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NPI Code Detail

MEDICARE: DR. ALIZA HASAN MD

MEDICARE: DR. ALIZA HASAN MD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207N00000XDermatology Physician036.175575IL

General Provider Information

NPI Number : 1518581149
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. ALIZA HASAN MD
Provider Business Mailing Address
First Line : PO BOX 19644
Second Line :
City : SPRINGFIELD
State : IL
Zip : 62794-9644
Country : US
Telephone Number : 217-545-8000
Fax Number :
Provider Business Practice Location Address
First Line : 4575 BENES AVE STE 375
Second Line :
City : GLEN CARBON
State : IL
Zip : 62034-1541
Country : US
Telephone Number : 618-961-1950
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/29/2020
Last Update Date : 01/30/2026

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