Individual
DR. BASEL I AL-ASWAD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2850 W 95TH ST, SUITE 406, EVERGREEN PARK, IL 60805-2735
(708) 499-4844
(708) 499-0731
Mailing address
2850 W 95TH ST, SUITE 406, EVERGREEN PARK, IL 60805-2735
(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
MEDICAL LICENCE
IL
01
—
200005125
MEDICARE ID-RAILROAD
IL
01
—
31602972
BC/BS NUMBER
IL
01
—
36-3618165
TAX IDENTIFICATION
—
Enumeration date
09/20/2005
Last updated
03/07/2023
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