MEDICARE: ZOHAIB HASSAN

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
1	213ES0103X	Foot & Ankle Surgery Podiatrist	135001130	IL

General Provider Information

NPI Number	:	1891377479
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ZOHAIB HASSAN

Provider Business Mailing Address
First Line	:	1843 CHASE DR
Second Line	:
City	:	ROCHESTER
State	:	MI
Zip	:	48307-6000
Country	:	US
Telephone Number	:	248-841-0111
Fax Number	:

Provider Business Practice Location Address
First Line	:	836 W WELLINGTON AVE
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60657-5147
Country	:	US
Telephone Number	:	975-773-1660
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/23/2021
Last Update Date	:	03/05/2026

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