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General NPI Number Information
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NPI Number | 1073596706
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Entity Type | Individual
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Provider Name | BASSEM ATASSI MD
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Gender | Male
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Dates
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Enumeration Date | 11/28/2005
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Last Update Date | 03/17/2018
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Provider Practice Location Address
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Address Line | 206 E 86TH PL
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City | MERRILLVILLE
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State | IN
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Zip | 46410-6258
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Country | US
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Telephone | 219-738-2722
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Fax | 219-736-7820
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Provider Business Mailing Address
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Address Line | 3707 DOTY ROAD CREDENTIALING - SUITE F
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City | WOODSTOCK
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State | IL
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Zip | 60098
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Country | US
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Telephone | 815-206-1068
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Fax | 815-337-5499
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208800000X
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Taxonomy Name | Urology Physician
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License Number | 036047780
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License Number State | IL
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Taxonomy #2
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Taxonomy Code | 208800000X
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Taxonomy Name | Urology Physician
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License Number | 01026618A
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License Number State | IN
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