Basic Information
| Provider Information | |||||||||
| NPI: | 1437105145 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | HADI | ||||||||
| FirstName: | SATTAR | ||||||||
| MiddleName: | A | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 275 THE CROSSROADS BLVD STE A | ||||||||
| Address2: | |||||||||
| City: | CARMEL | ||||||||
| State: | CA | ||||||||
| PostalCode: | 939238685 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8317189701 | ||||||||
| FaxNumber: | 8475357203 | ||||||||
| Practice Location | |||||||||
| Address1: | 1000 N WESTMORELAND RD | ||||||||
| Address2: | |||||||||
| City: | LAKE FOREST | ||||||||
| State: | IL | ||||||||
| PostalCode: | 600451658 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8472345600 | ||||||||
| FaxNumber: | 8475357203 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/25/2006 | ||||||||
| LastUpdateDate: | 02/15/2021 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 02/15/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 133N00000X | C168518 | CA | N | Dietary & Nutritional Service Providers | Nutritionist | 207P00000X | 38155 | TN | N | Allopathic & Osteopathic Physicians | Emergency Medicine | 207R00000X | C168518 | CA | N | Allopathic & Osteopathic Physicians | Internal Medicine | 208M00000X | 38155 | TN | N | Allopathic & Osteopathic Physicians | Hospitalist | 208M00000X | 036115780 | IL | Y | Allopathic & Osteopathic Physicians | Hospitalist |
ID Information
| ID | Type | State | Issuer | Description | 3891895 | 05 | TN | MEDICAID | 4128703 | 01 | TN | BLUE CROSS | OTHER | P00362709 | 01 | TN | MEDICARE RAILROAD | OTHER | 3891897 | 05 | TN | MEDICAID | 3891896 | 05 | TN | MEDICAID | 4152064 | 01 | TN | BLUE CROSS | OTHER | 009940603 | 05 | AL | MEDICAID | 4141160 | 01 | TN | BCBS | OTHER | 890-27808 | 01 | AL | BCBS | OTHER |