Provider Demographics
NPI:1477240315
Name:NASH, HUSSAM (MD, MPH)
Entity type:Individual
Prefix:DR
First Name:HUSSAM
Middle Name:
Last Name:NASH
Suffix:
Gender:M
Credentials:MD, MPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:106 S RIDGELAND AVE APT 401
Mailing Address - Street 2:
Mailing Address - City:OAK PARK
Mailing Address - State:IL
Mailing Address - Zip Code:60302-4617
Mailing Address - Country:US
Mailing Address - Phone:619-402-5999
Mailing Address - Fax:312-996-4169
Practice Address - Street 1:820 S WOOD ST STE 100
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60612-4325
Practice Address - Country:US
Practice Address - Phone:312-996-6906
Practice Address - Fax:312-996-4169
Is Sole Proprietor?:No
Enumeration Date:2023-04-20
Last Update Date:2024-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL125.085049390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program