Individual
NIDAL HASAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1747 E 87TH ST, B-390, CHICAGO, IL 60617-2741
(773) 978-4330
Mailing address
PO BOX 1200, ORLAND PARK, IL 60462-8200
(773) 820-0928
Taxonomy
Speciality
Code
Description
License number
State
207RE0101X
Endocrinology, Diabetes & Metabolism Physician
Primary
036091656
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
01621679
BCBS OF IL
IL
05
—
036091656
—
IL
Enumeration date
12/22/2005
Last updated
12/24/2021
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