Healthcare Provider Details

I. General information

NPI: 1053755710
Provider Name (Legal Business Name): ASIM KHAN BABAR M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/24/2013
Last Update Date: 05/06/2026
Certification Date: 05/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1050 E NORRIS DR STE 1B
OTTAWA IL
61350-1607
US

IV. Provider business mailing address

1050 E NORRIS DR STE 1B
OTTAWA IL
61350-1607
US

V. Phone/Fax

Practice location:
  • Phone: 815-434-0276
  • Fax: 815-434-0319
Mailing address:
  • Phone: 815-434-0276
  • Fax: 815-434-0319

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207UN0901X
TaxonomyNuclear Cardiology Physician
License Number036149959
License Number StateIL
# 2
Primary TaxonomyY
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License Number036149959
License Number StateIL
# 3
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number036149959
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: