Organization
DECATUR PSYCHIATRY LTD
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ANJUM BASHIR M.D. (OWNER)
(217) 809-0429
Entity
Organization
Contact information
Practice address
2580 E FEDERAL DR STE 403, DECATUR, IL 62526-2189
(217) 809-0429
(217) 422-0041
Mailing address
2580 E FEDERAL DR STE 403, DECATUR, IL 62526-2189
(217) 809-0429
(217) 422-0041
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
036105848
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036105848
—
IL
01
—
213272
MEDICARE
IL
Enumeration date
01/24/2007
Last updated
10/04/2024
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