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Individual

DR. ISHA B BASSI

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
DMD

Contact information

Practice address
2241 THEODORE ST, CREST HILL, IL 60403-1881
(815) 546-4269
Mailing address
2277 RIDGEWOOD RD, LISLE, IL 60532-3320
(815) 546-4269

Taxonomy

Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
019026079
IL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
019026079
LICENSE
IL
Enumeration date
12/01/2005
Last updated
03/15/2013
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