Independent US Healthcare Provider Directory & Public Medical Database
Active NPI 1265091128 Individual Practitioner Male Practitioner

Dr. Hasan Farid Hasan Othman , MD

Pediatrics • Jacksonville, IL

Professional Overview & Biography Verified Profile Summary

Dr. Hasan Othman, MD is a registered healthcare professional specializing in Pediatrics in Jacksonville, IL. Practice services are available at 15 FOUNDERS LN under active NPI credentials.

Practice Location & Contact Primary Location

Practice Address

15 Founders Ln

Jacksonville, IL 626503919

Telephone 2172430300
Fax 2172456775
Associated Practice Facility / Clinic

Specialty Benchmarks & Practice Insights

Comparative analytics for Pediatrics in Jacksonville, IL

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 10.5 Yrs
State Avg: 21.7 Yrs
Regional Practice Density
4 Specialists

Practicing in Jacksonville, IL (3277 Statewide)

Telehealth Adoption Rate
0.0% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
67.4% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Medical Specialties & State Licenses

CMS Verified: 2024-03-28
Pediatrics Primary Specialty

NUCC Taxonomy Code: 208000000X

State License IL 036160282

A pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development.

Additional State Medicaid & Healthcare Payer Identifiers

Commercial Insurance / Payer ID Il Md License
036160282 (IL)

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

16 Associated Practitioners
Denise Skinner , LCPC

Counselor - Professional

NPI 1093203093

Licensed Clinical Professional Counselor

Danica Mckain , APN

Nurse Practitioner - Pediatrics

NPI 1154712743

Advanced Practice Nurse

Molly Taylor , FNP

Nurse Practitioner - Family

NPI 1194196493

Family Nurse Practitioner

Dr. Edwin Mathews , DO

Internal Medicine

NPI 1225657125

Doctor of Osteopathic Medicine (D.O.)

Antonia Genisio , LCPC

Counselor - Professional

NPI 1245961606

Licensed Clinical Professional Counselor

Heather Lansaw , FNP

Nurse Practitioner - Family

NPI 1255563995

Family Nurse Practitioner

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

9 Historical Events
📍
Updated Practice Location August 02, 2022

Registered at 15 FOUNDERS LN, JACKSONVILLE, IL 626503919 (Tel: 2172430300)

📍
Updated Business Mailing Address August 02, 2022

Registered at 15 FOUNDERS LN, JACKSONVILLE, IL 626503919 (Tel: 2172430300)

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) August 02, 2022

Pediatrics (License #036160282 in IL)

NPI Profile Active June 13, 2019

NPI status registered as active in NPPES database

📍
Updated Practice Location June 13, 2019

Registered at 5303 S CEDAR ST STE 205, LANSING, MI 489113800 (Tel: 5178874305)

📍
Updated Business Mailing Address June 13, 2019

Registered at 5303 S CEDAR ST STE 205, LANSING, MI 489113800 (Tel: 5178874305)

👤
Provider Name / Credentials Updated June 13, 2019

Recorded as HASAN OTHMAN, MD

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) June 13, 2019

Pediatrics (License #4351045095 in MI)

🟢
Initial NPI Registration & Enumeration June 13, 2019

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1265091128
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: June 13, 2019
Last Update: March 28, 2024
Sole Proprietor: No

Mailing Address

15 Founders Ln

Jacksonville, IL 626503919

Phone: 2172430300

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).
⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.