Individual
SIDDIQ S HASAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
701 SUPERIOR AVE STE 2500, MUNSTER, IN 46321-4037
(219) 934-9852
(815) 836-7593
Mailing address
PO BOX 781076, DETROIT, MI 48278-1076
(317) 528-4800
(317) 865-1479
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
01087941A
IN
208600000X
Surgery Physician
036111304
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
9930030
BCBS OF ILLINOIS
IL
Enumeration date
02/23/2006
Last updated
05/06/2026
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