Individual
DR. AHSAN M BASHA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1490 E WALNUT ST STE A, WATSEKA, IL 60970-1806
(815) 432-0250
(815) 432-5217
Mailing address
1490 E WALNUT ST STE A, WATSEKA, IL 60970-1806
(815) 432-0250
(815) 432-5217
Taxonomy
Speciality
Code
Description
License number
State
207RH0003X
Hematology & Oncology Physician
30683
AZ
207RX0202X
Medical Oncology Physician
Primary
036093863
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036093863
—
IL
01
—
71173
MEDICARE ID
AZ
05
—
71613601
—
AZ
Enumeration date
02/10/2006
Last updated
03/22/2021
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