NPIMap

Organization Active NPI

Hassan H Youssef MD SC

  • Primary Care Clinic/Center
  • Bradley, IL
National Provider Identifier
1972763613
Registry record updated Dec 15, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Clinic/CenterTaxonomy code 261QP2300X
License
036-081606 Issued in IL
Legal business name
HASSAN H YOUSSEF MD SC
Practice address
400 S Kennedy Dr
Ste 900
Bradley, IL 60915-2682
Phone
(815) 932-3132
Fax
(815) 932-2397
NPI assigned
Jun 16, 2008
Last updated
Dec 15, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 15, 2022

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

Authorized official

Name
Ms. Angela Workman
Title
Office Manager
Phone
(815) 932-3132

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Care Clinic/Center 261QP2300X 036-081606 IL Primary

Addresses

Primary practice location

400 S Kennedy Dr
Ste 900
Bradley, IL 60915-2682

Mailing address

400 S Kennedy Dr
Ste 900
Bradley, IL 60915-2682
Phone (815) 932-3132

Other identifiers 1

IdentifierTypeStateIssuer
036081606MedicaidIL

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1213574400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1671062400000",
    "number": "1972763613",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "400 S KENNEDY DR",
            "address_2": "STE 900",
            "city": "BRADLEY",
            "state": "IL",
            "postal_code": "609152682",
            "telephone_number": "815-932-3132",
            "fax_number": "815-932-2397"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 S KENNEDY DR",
            "address_2": "STE 900",
            "city": "BRADLEY",
            "state": "IL",
            "postal_code": "609152682",
            "telephone_number": "815-932-3132",
            "fax_number": "815-932-2397"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HASSAN H YOUSSEF MD SC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-06-16",
        "last_updated": "2022-12-15",
        "certification_date": "2022-12-15",
        "status": "A",
        "authorized_official_last_name": "WORKMAN",
        "authorized_official_first_name": "ANGELA",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "815-932-3132",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": "IL",
            "license": "036-081606",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036081606",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bradley, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 15, 2022; 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.