Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208200000X | Surgeon | 036.119900 | IL |
Y | 208600000X | Surgeon | 036.119900 | IL |
N | 2082S0105X | Plastic Hand Surgeon | 036.119900 | IL |
NPI | 1992827224 |
---|---|
Provider Name | Jafar Syed Hasan |
First Address | Westmont, IL 60559-3506 |
Second Address | La Grange, IL 60559 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 06/04/2007 |
Last Update Date | 26/04/2021 |