Individual provider Active NPI

Aliza Hasan, MD

  • Dermatology Physician
  • Glen Carbon, IL
National Provider Identifier
1518581149
Registry record updated Jan 30, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
License
036.175575 Issued in IL
Practice address
4575 Benes Ave Ste 375
Glen Carbon, IL 62034-1541
Phone
(618) 961-1950
NPI assigned
May 29, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 30, 2026

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology Physician 207N00000X 036.175575 IL Primary

Addresses

Primary practice location

4575 Benes Ave Ste 375
Glen Carbon, IL 62034-1541

Mailing address

PO Box 19644
Springfield, IL 62794-9644
Phone (217) 545-8000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20251231003912 IL Practitioner - Dermatology 9335562974 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Dermatology
Education
Southern Illinois University School of Medicine, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
United Skin Specialists Illinois LTD PCGroup PAC ID 6709138258, 11 clinicians

Practice addresses (Care Compare)

4573 Benes Ave
Glen Carbon, IL 62034-1541
Phone (618) 244-0031

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision1-10
Removal of skin lesions35
Skin biopsy15

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
036.175575ILMDDermatology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
United Skin Specialists Illinois LTD, PC Dermatology CurrentSince Oct 1, 2025 Accepting new patients
Skin Care Center of Southern Il LLC PastSince Oct 1, 2025 Accepting new patients
Gibson Community Hospital Association Past Accepting new patients

Locations

4575 Benes Ave
Ste 375
Glen Carbon, IL 62034
Phone (618) 961-1950

4575 Benes Ave
Glen Carbon, IL 62034

4107 S Water Tower Pl
Mount Vernon, IL 62864
Phone (618) 244-0031

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1590710400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1769731200000",
    "number": "1518581149",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 19644",
            "city": "SPRINGFIELD",
            "state": "IL",
            "postal_code": "627949644",
            "telephone_number": "217-545-8000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4575 BENES AVE STE 375",
            "city": "GLEN CARBON",
            "state": "IL",
            "postal_code": "620341541",
            "telephone_number": "618-961-1950"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HASAN",
        "first_name": "ALIZA",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-05-29",
        "last_updated": "2026-01-30",
        "certification_date": "2026-01-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "IL",
            "license": "036.175575",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Glen Carbon, IL

Sources for this page

Verify at the official NPI Registry.