Healthcare Provider Details
I. General information
NPI: 1831052166
Provider Name (Legal Business Name): HAMZA SULTAN PA-C
Entity Type: Individual
Gender: Male
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 12/04/2025
Last Update Date: 12/04/2025
Certification Date: 12/04/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
2111 OGDEN AVE
AURORA IL
60504-7597
US
IV. Provider business mailing address
2000 OGDEN AVE STE P050
AURORA IL
60504-5893
US
V. Phone/Fax
- Phone: 630-978-3800
- Fax:
- Phone: 630-978-6200
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 363A00000X |
| Taxonomy | Physician Assistant |
| License Number | 085011552 |
| License Number State | IL |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: