Provider Demographics
NPI:1710694690
Name:NASER, HUSAM (PA-C)
Entity Type:Individual
Prefix:
First Name:HUSAM
Middle Name:
Last Name:NASER
Suffix:
Gender:M
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7356 W 84TH PL
Mailing Address - Street 2:
Mailing Address - City:BRIDGEVIEW
Mailing Address - State:IL
Mailing Address - Zip Code:60455-1707
Mailing Address - Country:US
Mailing Address - Phone:708-870-9198
Mailing Address - Fax:
Practice Address - Street 1:1851 SILVER CROSS BLVD STE 100
Practice Address - Street 2:
Practice Address - City:NEW LENOX
Practice Address - State:IL
Practice Address - Zip Code:60451-9599
Practice Address - Country:US
Practice Address - Phone:815-300-2727
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-11-01
Last Update Date:2022-11-01
Deactivation Date:
Deactivation Code:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant