Basic Information
Provider Information
NPI: 1306378534
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: ALADILI
FirstName: HASAN
MiddleName:  
NamePrefix: DR.
NameSuffix:  
Credential: M.D.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: PO BOX 776351
Address2:  
City: CHICAGO
State: IL
PostalCode: 606776351
CountryCode: US
TelephoneNumber: 5025889490
FaxNumber: 5022725116
Practice Location
Address1: 200 E CHESTNUT ST BLDG SUITE303
Address2:  
City: LOUISVILLE
State: KY
PostalCode: 402021831
CountryCode: US
TelephoneNumber: 5026295552
FaxNumber: 5026293132
Other Information
ProviderEnumerationDate: 03/28/2017
LastUpdateDate: 10/12/2020
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 10/12/2020

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207R00000X53637KYY Allopathic & Osteopathic PhysiciansInternal Medicine 

No ID Information.


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