Provider Demographics
NPI:1942310743
Name:HASAN, TOSEEF (OD)
Entity Type:Individual
Prefix:DR
First Name:TOSEEF
Middle Name:
Last Name:HASAN
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1721 E ROOSEVELT RD
Mailing Address - Street 2:UNIT#3
Mailing Address - City:WHEATON
Mailing Address - State:IL
Mailing Address - Zip Code:60187-6839
Mailing Address - Country:US
Mailing Address - Phone:630-605-2042
Mailing Address - Fax:
Practice Address - Street 1:1050 N ROHLWING RD
Practice Address - Street 2:
Practice Address - City:ADDISON
Practice Address - State:IL
Practice Address - Zip Code:60101-1034
Practice Address - Country:US
Practice Address - Phone:630-424-0038
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL46009608152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist