Individual
IFRA BADAR
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
2160 S 1ST AVE, MAYWOOD, IL 60153-3328
(904) 762-7311
Mailing address
2160 S 1ST AVE, MAYWOOD, IL 60153-3328
Taxonomy
Speciality
Code
Description
License number
State
207ZD0900X
Dermatopathology (Pathology) Physician
Primary
125.088477
IL
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
04/16/2021
Last updated
06/21/2026
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