Healthcare Provider Details

I. General information

NPI: 1447186507
Provider Name (Legal Business Name): DALAL M HASAN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/18/2026
Last Update Date: 06/18/2026
Certification Date: 06/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10821 S CHRISTA CT
PALOS HILLS IL
60465-2254
US

IV. Provider business mailing address

10821 S CHRISTA CT
PALOS HILLS IL
60465-2254
US

V. Phone/Fax

Practice location:
  • Phone: 708-833-1323
  • Fax:
Mailing address:
  • Phone: 708-833-1323
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number041.526015
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: