Organization Active NPI

Hassan Moghadam MD SC

  • Neurology Physician
  • Naperville, IL
National Provider Identifier
1932205671
Registry record updated Jul 16, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurology PhysicianTaxonomy code 2084N0400X
License
036057766 Issued in IL
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

Updated by the provider on Jul 16, 2008

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)CodeLicenseStatePrimary
Neurology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 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

IdentifierTypeStateIssuer
0002201310OtherILBCBS OF IL
036057766MedicaidIL

National Provider Directory

National Provider Directory

Locations

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.

Verify at the official NPI Registry.