Ifath G. Bashiruddin M.D.S.C.

Specialist · Belleville, IL

Organization Active NPI

NPI number 1821287293

Practice location

4550 Memorial Dr
Suite 410
Belleville, IL 62226-5359
Phone
(618) 234-8246
Fax
(618) 234-8271

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NPI record

NPI
1821287293
Entity type
Organization (Type 2)
Enumeration date
October 22, 2007
Last updated
November 5, 2007
Organization subpart
No

Specialties & taxonomy codes

TaxonomyCodeLicenseState
Specialist Primary 174400000X — IL

Mailing address

3415 Saluki Woods Rd
Belleville, IL 62223-7017
Phone
(618) 234-8246
Fax
(618) 234-8271

Authorized official

Name
Mr. Deborah Haake
Title
Business Manager
Phone
(618) 234-8246

About Ifath G. Bashiruddin M.D.S.C.

Ifath G. Bashiruddin M.D.S.C. is a healthcare organization registered in the NPI registry with the primary taxonomy Specialist (code 174400000X). The practice location is 4550 Memorial Dr, Suite 410, Belleville, IL 62226-5359. The NPI number 1821287293 was assigned on October 22, 2007 and the record was last updated on November 5, 2007.

The authorized official for this organization is Mr. Deborah Haake, Business Manager.

Frequently asked questions

What is the NPI number of Ifath G. Bashiruddin M.D.S.C.?

The NPI number is 1821287293.

What is the phone number of Ifath G. Bashiruddin M.D.S.C.?

The phone number listed for the practice location is (618) 234-8246.

Where is Ifath G. Bashiruddin M.D.S.C. located?

4550 Memorial Dr, Suite 410, Belleville, IL 62226-5359.

What is the taxonomy code for Ifath G. Bashiruddin M.D.S.C.?

The primary taxonomy code is 174400000X – Specialist.

Is this information correct?

All details come from the public NPPES registry. Providers can update their record at nppes.cms.hhs.gov; changes appear here after the next weekly update.

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