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Individual

HASSAN PERVAIZ

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
2601 W MAIN ST, CARBONDALE, IL 62901-1031
(618) 549-5361
(618) 351-4878
Mailing address
PO BOX 3988, CARBONDALE, IL 62902-3988
(618) 457-5200

Taxonomy

Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
036155408
IL
2084S0012X
Sleep Medicine (Psychiatry & Neurology) Physician
Primary
036155408
IL

Other

Enumeration date
07/13/2016
Last updated
01/03/2023
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