Individual
BASEL IMAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
100 SPALDING DR STE 406, NAPERVILLE, IL 60540-6554
(630) 961-9485
Mailing address
100 SPALDING DR STE 406, NAPERVILLE, IL 60540-6554
(630) 961-9485
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
000000
AZ
207V00000X
Obstetrics & Gynecology Physician
82607-20
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1245573542
—
WI
Enumeration date
04/04/2013
Last updated
09/19/2023
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