Provider Demographics
NPI:1548426745
Name:HASSAN, AHMED N (MD)
Entity Type:Individual
Prefix:DR
First Name:AHMED
Middle Name:N
Last Name:HASSAN
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 1:801 S. WASHINGTON ST
Mailing Address - Street 2:6TH FLOOR CNICU
Mailing Address - City:NAPERVILLE
Mailing Address - State:IL
Mailing Address - Zip Code:60540
Mailing Address - Country:US
Mailing Address - Phone:630-527-7235
Mailing Address - Fax:
Practice Address - Street 1:801 S. WASHINGTON ST
Practice Address - Street 2:6TH FLOOR CNICU
Practice Address - City:NAPERVILLE
Practice Address - State:IL
Practice Address - Zip Code:60540-6054
Practice Address - Country:US
Practice Address - Phone:630-527-7235
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-08-06
Last Update Date:2021-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO20100309262084N0400X
IL036121123207RC0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0200XAllopathic & Osteopathic PhysiciansInternal MedicineCritical Care Medicine
No2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
Provider Identifiers
StateIdentifier IDID TypeIssuer
ILP01308445OtherMEDICARE RAILROAD (INDIVIDUAL)
IL206147OtherMEDICARE PTAN (GROUP)
IL206147244OtherMEDICARE PTAN (INDIVIDUAL)
IL010030926Medicaid
ILCA4748OtherMEDICARE RAILROAD (GROUP)