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Individual

DR. HESHAM A HASSABALLA

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
2000 OGDEN AVE, AURORA, IL 60504-7222
(630) 978-6200
Mailing address
2000 OGDEN AVE, AURORA, IL 60504-7222
(630) 978-6210
(630) 898-6547

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
036105156
IL
207RC0200X
Critical Care Medicine (Internal Medicine) Physician
Primary
036105156
IL
207RC0200X
Critical Care Medicine (Internal Medicine) Physician
MD2025-0002
NM
207RP1001X
Pulmonary Disease Physician
036105156
IL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
02215074
BLUE SHIELD PROVIDER NUMB
IL
05
036105156
IL
Enumeration date
05/04/2006
Last updated
04/21/2025
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