Kieso, Hassan

Kieso, Hassan is an individual health care provider with primary practice located at 3800 W 203Rd St Suite 204, Olympia Fields IL 60461-1184. He recently has only one registered license in Allopathic & Osteopathic Physicians / Cardiovascular Disease, which is considered as his primary health care specialty. Kieso, Hassan can be contacted via phone (708) 679-2670.

Contact Information

Primary practice address
3800 W 203Rd St Suite 204 Olympia Fields IL 60461-1184
Phone: (708) 679-2670
Fax: (708) 503-3260
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Cardiovascular Disease 207RC0000X 036092223 Illinois

Profile Details

NPI number 1407812050
LBN Legal business name Kieso, Hassan
Credentials
Entity Individual
Sole proprietor 1 No
Enumeration date Apr 24th, 2006
Last updated Jan 10th, 2020 - about 6 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1407812050 NPPES
Illinois MEDICAID 036092223
Illinois Other L95559

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