Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RA0001X | Advanced Heart Failure and Transplant Cardiologist | 036143961 | IL |
N | 207RC0000X | Internist - Cardiovascular Disease | 036143961 | IL |
NPI | 1194039198 |
---|---|
Provider Name | Haseeb Ilias Basha |
First Address | Maywood, IL 60153-3328 |
Second Address | Maywood, IL 60153-3328 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 02/08/2010 |
Last Update Date | 12/08/2019 |