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NPI Code Detail

MEDICARE: SERENA M. BAQAI D.O.

MEDICARE: SERENA M. BAQAI D.O.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207P00000XEmergency Medicine Physician02006179AIN
2207P00000XEmergency Medicine Physician036112165IL

General Provider Information

NPI Number : 1376543488
Entity Type Code : Individual
Provider Name (Legal Business Name) : SERENA M. BAQAI D.O.
Provider Business Mailing Address
First Line : 2650 RIDGE AVE
Second Line :
City : EVANSTON
State : IL
Zip : 60201-1700
Country : US
Telephone Number : 847-570-2000
Fax Number :
Provider Business Practice Location Address
First Line : 2650 RIDGE AVE
Second Line :
City : EVANSTON
State : IL
Zip : 60201-1700
Country : US
Telephone Number : 847-570-2000
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/29/2005
Last Update Date : 06/14/2023

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Directions to “ SERENA M. BAQAI D.O.” Practice Location

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