Provider Demographics
NPI:1245321207
Name:HASAN, NAUSHEEN (MD)
Entity type:Individual
Prefix:
First Name:NAUSHEEN
Middle Name:
Last Name:HASAN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:NAUSHEEN
Other - Middle Name:
Other - Last Name:HASAN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:1595 MCCORMACK DR
Mailing Address - Street 2:
Mailing Address - City:HOFFMAN ESTATES
Mailing Address - State:IL
Mailing Address - Zip Code:60169-6966
Mailing Address - Country:US
Mailing Address - Phone:630-260-2409
Mailing Address - Fax:630-682-1960
Practice Address - Street 1:560 BELMONT LN
Practice Address - Street 2:
Practice Address - City:CAROL STREAM
Practice Address - State:IL
Practice Address - Zip Code:60188-2441
Practice Address - Country:US
Practice Address - Phone:630-682-1950
Practice Address - Fax:630-682-1960
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-27
Last Update Date:2011-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036096328207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL0360963282Medicaid
IL0360963282Medicaid
IL581200Medicare ID - Type Unspecified