Individual
KHONDAKAR A HASANAT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
12255 S 80TH AVE, SUITE 202, PALOS HEIGHTS, IL 60463-1270
(708) 923-7878
(708) 923-7888
Mailing address
12251 S 80TH AVE STE 1630, PALOS HEIGHTS, IL 60463-1256
(708) 923-7878
(708) 923-7888
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
036098281
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036098281
—
IL
Enumeration date
09/26/2006
Last updated
11/29/2021
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