Provider Demographics
NPI:1528679347
Name:HCPAN LLC
Entity type:Organization
Organization Name:HCPAN LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ADEL
Authorized Official - Middle Name:
Authorized Official - Last Name:MOURADI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:708-829-2198
Mailing Address - Street 1:1042 MAPLE AVE STE 335
Mailing Address - Street 2:
Mailing Address - City:LISLE
Mailing Address - State:IL
Mailing Address - Zip Code:60532-2329
Mailing Address - Country:US
Mailing Address - Phone:708-336-0419
Mailing Address - Fax:708-221-6766
Practice Address - Street 1:12450 WALKER RD
Practice Address - Street 2:
Practice Address - City:LEMONT
Practice Address - State:IL
Practice Address - Zip Code:60439-9301
Practice Address - Country:US
Practice Address - Phone:708-478-7201
Practice Address - Fax:708-221-6766
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:HOSPITALIST CONSULTANTS GROUP S.C.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2020-08-14
Last Update Date:2020-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGroup - Single Specialty