Organization
SIDDIQ HASAN MD LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. SIDDIQ HASAN M. D. (DIRECTOR)
(815) 272-7233
Entity
Organization
Contact information
Practice address
7531 S STONY ISLAND AVE, CHICAGO, IL 60649-3954
(773) 947-7587
Mailing address
205 RIVER CT, MINOOKA, IL 60447-9368
(815) 272-7233
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
036-111304
IL
Other
Enumeration date
04/25/2008
Last updated
05/05/2008
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