Provider Demographics
NPI:1538574892
Name:HOSEIN, ABDEL NASSER (MD, PHD)
Entity type:Individual
Prefix:DR
First Name:ABDEL
Middle Name:NASSER
Last Name:HOSEIN
Suffix:
Gender:M
Credentials:MD, PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 735044
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60673-5044
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2900 W OKLAHOMA AVE
Practice Address - Street 2:
Practice Address - City:MILWAUKEE
Practice Address - State:WI
Practice Address - Zip Code:53215-4330
Practice Address - Country:US
Practice Address - Phone:414-649-6380
Practice Address - Fax:414-649-5389
Is Sole Proprietor?:No
Enumeration Date:2014-06-25
Last Update Date:2023-12-11
Deactivation Date:2015-01-29
Deactivation Code:
Reactivation Date:2015-03-04
Provider Licenses
StateLicense IDTaxonomies
WI74420207RH0003X, 207RH0003X
TXBP10050429207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI100139706Medicaid