Healthcare Provider Details

I. General information

NPI: 1164462941
Provider Name (Legal Business Name): BASSAM F MATAR MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/08/2006
Last Update Date: 10/06/2025
Certification Date: 10/06/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2000 GOLF RD
ROLLING MEADOWS IL
60008
US

IV. Provider business mailing address

2000 GOLF RD
ROLLING MEADOWS IL
60008-4216
US

V. Phone/Fax

Practice location:
  • Phone: 847-871-1800
  • Fax: 847-629-4937
Mailing address:
  • Phone: 847-871-1800
  • Fax: 847-871-5777

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RH0003X
TaxonomyHematology & Oncology Physician
License Number036095552
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: