Healthcare Provider Details

I. General information

NPI: 1194914093
Provider Name (Legal Business Name): ALZEIN MEDICAL LTD
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/17/2007
Last Update Date: 10/23/2023
Certification Date: 03/08/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2850 W 95TH ST STE 400
EVERGREEN PARK IL
60805-2755
US

IV. Provider business mailing address

2850 W 95TH ST STE 400
EVERGREEN PARK IL
60805-2755
US

V. Phone/Fax

Practice location:
  • Phone: 708-424-7600
  • Fax: 708-424-7605
Mailing address:
  • Phone: 708-424-7600
  • Fax: 708-424-7605

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
License Number036088165
License Number StateIL
# 2
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number036088165
License Number StateIL

VIII. Authorized Official

Name: HASSAN ALZEIN
Title or Position: PRESIDENT/OWNER
Credential: M.D.
Phone: 708-424-7600