Active NPI
Mohamad Ahmed Hassan, PT
- Physical Therapist
- Orland Park, IL
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 070024359
- Practice address
- 14474 S la Grange Rd
Orland Park, IL 60462-2506 - Phone
- (084) 608-0807
- Fax
- (630) 920-4687
- NPI assigned
- Jun 4, 2019
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 070024359 | IL | Primary |
Addresses
Primary practice location
14474 S la Grange Rd
Orland Park, IL 60462-2506
Mailing address
570 Village Center Dr Ste 205
Burr Ridge, IL 60527-4526
Phone (630) 920-4670
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in IL, IN
Enrollment records 2
Care Compare profile
Medicare Care Compare- Specialty
- Physical Therapist in Private Practice
- Education
- Des Moines University of Osteopathic Medicine and Health Sciences, 2019
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
3900 W 95TH St
Evergreen Park, IL 60805-1922
Phone 63092046706
8159 Calumet Ave
Munster, IN 46321-1701
Phone (630) 920-4670
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 070024359 | IL | MD | Physical Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Premier Physical Therapy PC | Physical Therapist | Current | Accepting new patients |
Locations
570 Village Center Dr
Ste 205
Burr Ridge, IL 60527
4455 W Grand Ave
Chicago, IL 60639
Phone (630) 575-6250
14474 S La Grange Rd
Orland Park, IL 60462
Phone (708) 460-8080
8159 Calumet Ave
Munster, IN 46321
Phone (219) 836-2800
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1559606400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1726531200000",
"number": "1487212536",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "570 VILLAGE CENTER DR STE 205",
"city": "BURR RIDGE",
"state": "IL",
"postal_code": "605274526",
"telephone_number": "630-920-4670",
"fax_number": "630-920-4687"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "14474 S LA GRANGE RD",
"city": "ORLAND PARK",
"state": "IL",
"postal_code": "604622506",
"telephone_number": "084-608-0807",
"fax_number": "630-920-4687"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HASSAN",
"first_name": "MOHAMAD",
"middle_name": "AHMED",
"name_prefix": "Dr.",
"credential": "PT",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2019-06-04",
"last_updated": "2024-09-17",
"certification_date": "2024-09-17",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "IL",
"license": "070024359",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Orland Park, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 17, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.