Provider Demographics
NPI:1568605806
Name:MOTEN, HADI (MD)
Entity Type:Individual
Prefix:DR
First Name:HADI
Middle Name:
Last Name:MOTEN
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 1:431 SUMMIT ST
Mailing Address - Street 2:
Mailing Address - City:ELGIN
Mailing Address - State:IL
Mailing Address - Zip Code:60120-3805
Mailing Address - Country:US
Mailing Address - Phone:847-289-8822
Mailing Address - Fax:847-289-0815
Practice Address - Street 1:431 SUMMIT ST
Practice Address - Street 2:
Practice Address - City:ELGIN
Practice Address - State:IL
Practice Address - Zip Code:60120-3805
Practice Address - Country:US
Practice Address - Phone:847-289-8822
Practice Address - Fax:847-289-0815
Is Sole Proprietor?:No
Enumeration Date:2009-04-16
Last Update Date:2023-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY271682207LP2900X
NV21123207LP2900X
IL036.161384208VP0014X, 207LP2900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207LP2900XAllopathic & Osteopathic PhysiciansAnesthesiologyPain Medicine
No208VP0014XAllopathic & Osteopathic PhysiciansPain MedicineInterventional Pain Medicine