Provider Demographics
NPI:1437105145
Name:HADI, SATTAR A (MD)
Entity Type:Individual
Prefix:DR
First Name:SATTAR
Middle Name:A
Last Name:HADI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:275 THE CROSSROADS BLVD STE A
Mailing Address - Street 2:
Mailing Address - City:CARMEL
Mailing Address - State:CA
Mailing Address - Zip Code:93923-8685
Mailing Address - Country:US
Mailing Address - Phone:831-718-9701
Mailing Address - Fax:847-535-7203
Practice Address - Street 1:1000 N WESTMORELAND RD
Practice Address - Street 2:
Practice Address - City:LAKE FOREST
Practice Address - State:IL
Practice Address - Zip Code:60045-1658
Practice Address - Country:US
Practice Address - Phone:847-234-5600
Practice Address - Fax:847-535-7203
Is Sole Proprietor?:No
Enumeration Date:2006-05-25
Last Update Date:2021-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAC168518133N00000X, 207R00000X
TN38155207P00000X, 208M00000X
IL036115780208M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208M00000XAllopathic & Osteopathic PhysiciansHospitalist
No133N00000XDietary & Nutritional Service ProvidersNutritionist
No207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN3891895Medicaid
TN4128703OtherBLUE CROSS
TNP00362709OtherMEDICARE RAILROAD
TN3891897Medicaid
TN3891896Medicaid
TN4152064OtherBLUE CROSS
AL009940603Medicaid
TN4141160OtherBCBS
AL890-27808OtherBCBS
TN3891895Medicaid
TN3891895Medicare PIN
TN4128703OtherBLUE CROSS
TNP00362709OtherMEDICARE RAILROAD
TN3891896Medicare PIN