Active NPI
Hassan Moghadam MD SC
- Neurology Physician
- Naperville, IL
National Provider Identifier
1932205671
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Neurology Physician
- License
- 036057766
- Legal business name
- HASSAN MOGHADAM MD SC
- Practice address
- 120 Spalding Dr
Suite 407
Naperville, IL 60540-6508 - Phone
- (630) 357-4260
- NPI assigned
- Sep 16, 2006
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Hassan A Moghadam, MD
- Title
- Owner / MD
- Phone
- (630) 357-4260
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Neurology Physician | 2084N0400X | 036057766 | IL | Primary |
Addresses
Primary practice location
120 Spalding Dr
Suite 407
Naperville, IL 60540-6508
Mailing address
PO Box 967
Tinley Park, IL 60477-0967
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0002201310 | Other | IL | BCBS OF IL |
| 036057766 | Medicaid | IL |
National Provider Directory
National Provider DirectoryLocations
120 Spalding Dr
Ste 407
Naperville, IL 60540
Phone (630) 357-4260
Practitioners & affiliated clinicians
Practitioners 1
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1158364800000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1216166400000",
"number": "1932205671",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 967",
"city": "TINLEY PARK",
"state": "IL",
"postal_code": "604770967"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "120 SPALDING DR",
"address_2": "SUITE 407",
"city": "NAPERVILLE",
"state": "IL",
"postal_code": "605406508",
"telephone_number": "630-357-4260"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "HASSAN MOGHADAM MD SC",
"organizational_subpart": "NO",
"enumeration_date": "2006-09-16",
"last_updated": "2008-07-16",
"status": "A",
"authorized_official_last_name": "MOGHADAM",
"authorized_official_first_name": "HASSAN",
"authorized_official_middle_name": "A",
"authorized_official_title_or_position": "OWNER / MD",
"authorized_official_telephone_number": "630-357-4260",
"authorized_official_credential": "MD"
},
"taxonomies": [
{
"code": "2084N0400X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Psychiatry & Neurology, Neurology",
"state": "IL",
"license": "036057766",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS OF IL",
"identifier": "0002201310",
"state": "IL"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "036057766",
"state": "IL"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Naperville, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 16, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.