Individual provider Active NPI

Dina Salah Mohamed Aly Hassan

  • Anatomic Pathology & Clinical Pathology Physician
  • Chicago, IL
National Provider Identifier
1730768292
Registry record updated Jun 24, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anatomic Pathology & Clinical Pathology PhysicianTaxonomy code 207ZP0102X
License
125.077464 Issued in IL
Practice address
600 S Paulina St Ste 403
Chicago, IL 60612-3806
Phone
(312) 942-0312
NPI assigned
Apr 2, 2021
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 24, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anatomic Pathology & Clinical Pathology Physician 207ZP0102X 125.077464 IL Primary

Addresses

Primary practice location

600 S Paulina St Ste 403
Chicago, IL 60612-3806

Mailing address

600 S Paulina St Ste 403
Chicago, IL 60612-3806
Phone (312) 942-0312

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
I20210720000123 IL Order and Referring Only - PathologyPractitioner - Pathology 2961805619

Care Compare profile

Medicare Care Compare
Specialty
Pathology
Education
Other, 2015
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

1919 S Highland Ave
Building a Suite 210
Lombard, IL 60148-6153

3010 Highland Pkwy
Suite 325
Downers Grove, IL 60515-5659

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
125.077464ILMDAnatomic Pathology & Clinical Pathology Physician

NPI Registry JSON

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

{
    "created_epoch": "1617321600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1624492800000",
    "number": "1730768292",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "600 S PAULINA ST STE 403",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606123806",
            "telephone_number": "312-942-0312"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "600 S PAULINA ST STE 403",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606123806",
            "telephone_number": "312-942-0312"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HASSAN",
        "first_name": "DINA",
        "middle_name": "SALAH MOHAMED ALY",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-04-02",
        "last_updated": "2021-06-24",
        "certification_date": "2021-06-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207ZP0102X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": "IL",
            "license": "125.077464",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.