Provider Demographics
NPI:1922104025
Name:ALZEIN, HASSAN (MD)
Entity Type:Individual
Prefix:
First Name:HASSAN
Middle Name:
Last Name:ALZEIN
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 1:2850 W 95TH ST
Mailing Address - Street 2:SUITE 400
Mailing Address - City:EVERGREEN PARK
Mailing Address - State:IL
Mailing Address - Zip Code:60805-2735
Mailing Address - Country:US
Mailing Address - Phone:708-424-7600
Mailing Address - Fax:708-424-7605
Practice Address - Street 1:2850 W 95TH ST
Practice Address - Street 2:SUITE 400
Practice Address - City:EVERGREEN PARK
Practice Address - State:IL
Practice Address - Zip Code:60805-2735
Practice Address - Country:US
Practice Address - Phone:708-424-7600
Practice Address - Fax:708-424-7605
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-15
Last Update Date:2023-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036088165208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL036088165Medicaid
ILF77416Medicare UPIN