Provider Demographics
NPI:1215971965
Name:HASAN, MUNEER S
Entity type:Individual
Prefix:
First Name:MUNEER
Middle Name:S
Last Name:HASAN
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2900 W PETERSON AVE
Mailing Address - Street 2:SUITE 11
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60659-3818
Mailing Address - Country:US
Mailing Address - Phone:773-544-1249
Mailing Address - Fax:
Practice Address - Street 1:2900 W PETERSON AVE
Practice Address - Street 2:SUITE 11
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60659-3818
Practice Address - Country:US
Practice Address - Phone:773-544-1249
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-06-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL247100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes247100000XTechnologists, Technicians & Other Technical Service ProvidersRadiologic Technologist