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Organization
BASEL AL-ASWAD M D S C
Active
Organization
BASEL AL-ASWAD M D S C
Active
Other names
Evergreen Orthopedics SC
Organization subpart
No
Provider details
NPI number
Authorized official
DR. BASEL I AL-ASWAD MD (PRESIDENT)
(708) 499-4844
Entity
Organization
Contact information
Practice address
2850 W 95TH ST, SUITE 406, EVERGREEN PARK, IL 60805-2790
(708) 499-4844
(708) 499-0731
Mailing address
2850 W 95TH ST, SUITE 406, EVERGREEN PARK, IL 60805-2790
(708) 499-4844
(708) 499-0731
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
036048539
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
036048539
LICENSE NUMBER
IL
01
—
31602972
BCBS PROVIDER #
IL
01
—
CG7199
MEDICARE ID-RAILROAD
IL
Enumeration date
01/30/2007
Last updated
03/07/2023
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