Healthcare Provider Details

I. General information

NPI: 1013224732
Provider Name (Legal Business Name): ZAHID ALEEM HASAN MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

Provider Other Name: ZAHID ALEEM ULLAH MD

II. Dates (important events)

Enumeration Date: 09/01/2010
Last Update Date: 07/16/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2875 W 19TH ST 3RD FLOOR, PEDIATRICS
CHICAGO IL
60623-3501
US

IV. Provider business mailing address

1901 W HARRISON ST 4TH FLOOR, NICU
CHICAGO IL
60612-3714
US

V. Phone/Fax

Practice location:
  • Phone: 773-484-4065
  • Fax:
Mailing address:
  • Phone: 312-864-4010
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number036118010
License Number StateIL
# 2
Primary TaxonomyN
Taxonomy Code2080N0001X
TaxonomyNeonatal-Perinatal Medicine Physician
License Number036118010
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: