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NPI Code Detail

MEDICARE: HAMDARD HEALTH ALLIANCE

MEDICARE: HAMDARD HEALTH ALLIANCE
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1261QF0400XFederally Qualified Health Center (FQHC)

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1781811OTHERILPTAN

General Provider Information

NPI Number : 1609875053
Entity Type Code : Organization
Provider Name (Legal Business Name) : HAMDARD HEALTH ALLIANCE
Provider Business Mailing Address
First Line : 228 E LAKE ST
Second Line :
City : ADDISON
State : IL
Zip : 60101-2889
Country : US
Telephone Number : 630-835-1430
Fax Number : 630-835-1433
Provider Business Practice Location Address
First Line : 228 E LAKE ST
Second Line :
City : ADDISON
State : IL
Zip : 60101-2889
Country : US
Telephone Number : 630-835-1430
Fax Number :
Authorized Official
Title or Position : FINANCE ADMINISTRATION MANAGER
Name : MS. SHAWN BAILEY
Credential :
Telephone Number : 630-835-1430
Provider Enumeration Date : 07/19/2005
Last Update Date : 12/26/2023

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Directions to “HAMDARD HEALTH ALLIANCE ” Practice Location

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