Individual
RIYA BASU
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
1645 W JACKSON BLVD, CHICAGO, IL 60612-3276
(312) 942-2200
Mailing address
700 W VAN BUREN ST APT 1406, CHICAGO, IL 60607-3619
(404) 631-7444
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
125.069230
IL
Other
Enumeration date
06/14/2016
Last updated
06/27/2019
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