Provider Demographics
NPI:1710967955
Name:ALHAJ-HUSSEIN, YASSER A (MD)
Entity Type:Individual
Prefix:DR
First Name:YASSER
Middle Name:A
Last Name:ALHAJ-HUSSEIN
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 1:1554 TODD FARM DR
Mailing Address - Street 2:SUITE 350
Mailing Address - City:ELGIN
Mailing Address - State:IL
Mailing Address - Zip Code:60123-1287
Mailing Address - Country:US
Mailing Address - Phone:815-274-0779
Mailing Address - Fax:
Practice Address - Street 1:350 N WALL ST
Practice Address - Street 2:DEPT OF ANESTHESESIA
Practice Address - City:KANKAKEE
Practice Address - State:IL
Practice Address - Zip Code:60901-2901
Practice Address - Country:US
Practice Address - Phone:815-933-1671
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-01-21
Last Update Date:2016-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036100713207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL036100713Medicaid
CO76809315Medicaid
ILK41126Medicare PIN
CO502118Medicare PIN
H49083Medicare UPIN