Healthcare Provider Details

I. General information

NPI: 1487564605
Provider Name (Legal Business Name): HOSAM ASAL CSFA
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/09/2026
Last Update Date: 09/09/2026
Certification Date: 09/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1815 LARGO CT
SCHAUMBURG IL
60194-2227
US

IV. Provider business mailing address

1815 LARGO CT
SCHAUMBURG IL
60194-2227
US

V. Phone/Fax

Practice location:
  • Phone: 541-908-1608
  • Fax:
Mailing address:
  • Phone: 541-908-1608
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code246ZC0007X
TaxonomySurgical Assistant
License Number238.010856
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: