Provider Demographics
NPI:1225257694
Name:BASHIR, HAMID (MD)
Entity Type:Individual
Prefix:
First Name:HAMID
Middle Name:
Last Name:BASHIR
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:210 N HAMMES AVE STE 110
Mailing Address - Street 2:
Mailing Address - City:JOLIET
Mailing Address - State:IL
Mailing Address - Zip Code:60435-6688
Mailing Address - Country:US
Mailing Address - Phone:815-582-3026
Mailing Address - Fax:815-582-3025
Practice Address - Street 1:210 N HAMMES AVE STE 110
Practice Address - Street 2:
Practice Address - City:JOLIET
Practice Address - State:IL
Practice Address - Zip Code:60435-6688
Practice Address - Country:US
Practice Address - Phone:815-582-3026
Practice Address - Fax:815-582-3025
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-24
Last Update Date:2021-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036148640207RR0500X
MO2009017530207RR0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RR0500XAllopathic & Osteopathic PhysiciansInternal MedicineRheumatologyGroup - Single Specialty