Healthcare Provider Details

I. General information

NPI: 1700328788
Provider Name (Legal Business Name): LIMITLESS MEDICAL GROUP, LTD
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/08/2016
Last Update Date: 11/08/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

535 N MICHIGAN AVE APT 2915
CHICAGO IL
60611-3814
US

IV. Provider business mailing address

535 N MICHIGAN AVE APT 2915
CHICAGO IL
60611-3814
US

V. Phone/Fax

Practice location:
  • Phone: 951-235-1070
  • Fax:
Mailing address:
  • Phone: 951-235-1070
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number036141730
License Number StateIL

VIII. Authorized Official

Name: AMIR BADAR
Title or Position: PRESIDENT
Credential: M.D.
Phone: 951-235-1070