Healthcare Provider Details

I. General information

NPI: 1336072263
Provider Name (Legal Business Name): HADI DOSSANI
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/08/2026
Last Update Date: 06/08/2026
Certification Date: 06/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

121 N ADDISON AVE
ELMHURST IL
60126-2809
US

IV. Provider business mailing address

5305 BIRCH BARK DR
HOFFMAN ESTATES IL
60192-4142
US

V. Phone/Fax

Practice location:
  • Phone: 630-409-0471
  • Fax:
Mailing address:
  • Phone: 847-800-0071
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: