Provider Demographics
NPI:1508150418
Name:BELIN, RASHAD JABALI (MD, PHD)
Entity Type:Individual
Prefix:DR
First Name:RASHAD
Middle Name:JABALI
Last Name:BELIN
Suffix:
Gender:M
Credentials:MD, PHD
Other - Prefix:DR
Other - First Name:RASHAD
Other - Middle Name:JAB-ALI
Other - Last Name:BELIN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:1040 SIERRA DR STE 400
Mailing Address - Street 2:
Mailing Address - City:GREENWOOD
Mailing Address - State:IN
Mailing Address - Zip Code:46143-7241
Mailing Address - Country:US
Mailing Address - Phone:317-528-4800
Mailing Address - Fax:
Practice Address - Street 1:3800 W 203RD ST STE 204
Practice Address - Street 2:
Practice Address - City:OLYMPIA FIELDS
Practice Address - State:IL
Practice Address - Zip Code:60461-1185
Practice Address - Country:US
Practice Address - Phone:708-679-2380
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-06-08
Last Update Date:2021-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036135498207R00000X, 208M00000X, 207RI0011X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0011XAllopathic & Osteopathic PhysiciansInternal MedicineInterventional Cardiology
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No208M00000XAllopathic & Osteopathic PhysiciansHospitalist
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL036135498Medicaid
IL125059719OtherILLINOIS DIVISION OF PROFESSIONAL REGULATION
INM147140303OtherMEDICARE IN
ILF400571260OtherMEDICARE