Healthcare Provider Details

I. General information

NPI: 1508015181
Provider Name (Legal Business Name): BASHARAT H MUNEER M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/18/2008
Last Update Date: 07/20/2020
Certification Date: 07/20/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2088 OGDEN AVENUE SUITE 160
AURORA IL
60504
US

IV. Provider business mailing address

2088 OGDEN AVE STE 160
AURORA IL
60504-4383
US

V. Phone/Fax

Practice location:
  • Phone: 630-851-6440
  • Fax: 630-851-7001
Mailing address:
  • Phone: 630-851-6440
  • Fax: 630-851-7001

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License Number036110176
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: