Individual
MARIA I AL-BASHA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
1639 N ALPINE RD, ROCKFORD, IL 61107-1449
(815) 229-9333
Mailing address
PO BOX 775541, CHICAGO, IL 60677-5541
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
036079495
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036079495
—
IL
Enumeration date
09/27/2006
Last updated
03/20/2026
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