Provider Demographics
NPI:1508364126
Name:HASAN PSYCHOLOGICAL SERVICES, LLC
Entity Type:Organization
Organization Name:HASAN PSYCHOLOGICAL SERVICES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/ PSYCHOLOGIST
Authorized Official - Prefix:DR
Authorized Official - First Name:NADIA
Authorized Official - Middle Name:T
Authorized Official - Last Name:HASAN
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:224-500-6840
Mailing Address - Street 1:1444 ALBANY CT APT 201
Mailing Address - Street 2:
Mailing Address - City:SCHAUMBURG
Mailing Address - State:IL
Mailing Address - Zip Code:60193-3587
Mailing Address - Country:US
Mailing Address - Phone:224-500-6840
Mailing Address - Fax:
Practice Address - Street 1:222 MERCHANDISE MART PLZ STE 432
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60654-1030
Practice Address - Country:US
Practice Address - Phone:224-500-6840
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-01-29
Last Update Date:2018-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL071.009551103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty