Individual
AHMAD HASAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
3320 CHICAGO RD, SOUTH CHICAGO HEIGHTS, IL 60411-5423
(708) 567-8610
Mailing address
13726 LEGEND TRAIL LN, ORLAND PARK, IL 60462-1104
(708) 567-8610
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
019.032606
IL
Other
Enumeration date
07/10/2020
Last updated
07/10/2020
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