Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RN0300X | Nephrologist | 036050525 | IL |
NPI | 1033279815 |
---|---|
Provider Name | Asad A Bakir |
First Address | River Forest, IL 60305 |
Second Address | River Forest, IL 60305 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 11/12/2006 |
Last Update Date | 10/11/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0021608880 | BCBS (01) | IL |
036050525 | (05) | IL |
D14112 | (02) |