Healthcare Provider Details

I. General information

NPI: 1225257694
Provider Name (Legal Business Name): HAMID BASHIR MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/24/2007
Last Update Date: 08/04/2025
Certification Date: 08/04/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3524 E MILWAUKEE ST
JANESVILLE WI
53546-1626
US

IV. Provider business mailing address

2350 N ROCKTON AVE
ROCKFORD IL
61103-3600
US

V. Phone/Fax

Practice location:
  • Phone: 608-756-7100
  • Fax: 608-756-7225
Mailing address:
  • Phone: 847-971-2007
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RR0500X
TaxonomyRheumatology Physician
License Number036148640
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: