Provider Demographics
NPI:1003006974
Name:HASSAN CHAHADEH MDPA
Entity Type:Organization
Organization Name:HASSAN CHAHADEH MDPA
Other - Org Name:MMG
Other - Org Type:Other Name
Authorized Official - Title/Position:CREDENTIALLING SPECIALIST
Authorized Official - Prefix:
Authorized Official - First Name:ANITA
Authorized Official - Middle Name:
Authorized Official - Last Name:SINGH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:630-926-3408
Mailing Address - Street 1:1000 JORIE BLVD STE 370
Mailing Address - Street 2:
Mailing Address - City:OAK BROOK
Mailing Address - State:IL
Mailing Address - Zip Code:60523-4512
Mailing Address - Country:US
Mailing Address - Phone:630-413-4307
Mailing Address - Fax:713-802-1511
Practice Address - Street 1:9079 KATY FWY STE C
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77024-1637
Practice Address - Country:US
Practice Address - Phone:832-582-7269
Practice Address - Fax:844-756-0668
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-07-27
Last Update Date:2018-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXJ6083207LP2900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207LP2900XAllopathic & Osteopathic PhysiciansAnesthesiologyPain MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX163540101Medicaid
TX0063JSOtherBCBS