Healthcare Provider Details

I. General information

NPI: 1548426745
Provider Name (Legal Business Name): AHMED N HASSAN MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/06/2008
Last Update Date: 02/04/2021
Certification Date: 01/19/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

801 S. WASHINGTON ST 6TH FLOOR CNICU
NAPERVILLE IL
60540-6054
US

IV. Provider business mailing address

801 S. WASHINGTON ST 6TH FLOOR CNICU
NAPERVILLE IL
60540
US

V. Phone/Fax

Practice location:
  • Phone: 630-527-7235
  • Fax:
Mailing address:
  • Phone: 630-527-7235
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RC0200X
TaxonomyCritical Care Medicine (Internal Medicine) Physician
License Number036121123
License Number StateIL
# 2
Primary TaxonomyN
Taxonomy Code2084N0400X
TaxonomyNeurology Physician
License Number2010030926
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: