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General NPI Number Information
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NPI Number | 1174092993
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Entity Type | Organization
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Legal Business Name | BUSHRA HAIDER MD LLC
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Dates
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Enumeration Date | 11/21/2018
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Last Update Date | 03/29/2019
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Provider Practice Location Address
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Address Line | 2001 MIDWEST RD STE 110
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City | OAK BROOK
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State | IL
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Zip | 60523-4300
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Country | US
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Telephone | 630-360-2646
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Fax |
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Provider Business Mailing Address
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Address Line | 6103 TYRNBURY DR
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City | LISLE
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State | IL
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Zip | 60532-3200
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Country | US
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Telephone | 412-979-3470
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Fax | 630-932-8025
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Authorized Official
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Title or Position | PRESIDENT
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Name | BUSHRA HAIDER
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Credential | MD
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Telephone | 630-932-8000
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State |
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