Individual
ERIC BASAPPA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
420 E SUPERIOR ST STE 9-900, CHICAGO, IL 60611-4494
(131) 250-3797
Mailing address
420 E SUPERIOR ST STE 9-900, CHICAGO, IL 60611-4494
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
036168064
IL
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
03/24/2019
Last updated
05/28/2024
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