Provider Demographics
NPI:1740412246
Name:NASSAR, HAZEM (MD)
Entity Type:Individual
Prefix:
First Name:HAZEM
Middle Name:
Last Name:NASSAR
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 1:4600 N CLARENDON AVE
Mailing Address - Street 2:APT 1109
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60640-5710
Mailing Address - Country:US
Mailing Address - Phone:773-293-7133
Mailing Address - Fax:
Practice Address - Street 1:4600 N CLARENDON AVE
Practice Address - Street 2:APT 1109
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60640-5710
Practice Address - Country:US
Practice Address - Phone:773-293-7133
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-08-17
Last Update Date:2022-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL125056257207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine