Provider Demographics
NPI:1346537826
Name:RAISSI, SASAN RYAN (MD)
Entity Type:Individual
Prefix:DR
First Name:SASAN
Middle Name:RYAN
Last Name:RAISSI
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:4230 HARDING PIKE
Mailing Address - Street 2:STE 430
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37205-4901
Mailing Address - Country:US
Mailing Address - Phone:615-269-4545
Mailing Address - Fax:615-565-6748
Practice Address - Street 1:676 N SAINT CLAIR ST STE 600
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60611-2981
Practice Address - Country:US
Practice Address - Phone:312-695-0070
Practice Address - Fax:312-695-0063
Is Sole Proprietor?:No
Enumeration Date:2011-07-05
Last Update Date:2022-07-21
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MO2016044221207RC0000X
TN5937207RC0000X
IL036.142506207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease