MEDICARE: LIMITLESS MEDICAL GROUP, LTD

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
1	2084P0800X	Psychiatry Physician	036141730	IL

General Provider Information

NPI Number	:	1700328788
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	LIMITLESS MEDICAL GROUP, LTD

Provider Business Mailing Address
First Line	:	535 N MICHIGAN AVE
Second Line	:	APT 2915
City	:	CHICAGO
State	:	IL
Zip	:	60611-3814
Country	:	US
Telephone Number	:	951-235-1070
Fax Number	:

Provider Business Practice Location Address
First Line	:	535 N MICHIGAN AVE
Second Line	:	APT 2915
City	:	CHICAGO
State	:	IL
Zip	:	60611-3814
Country	:	US
Telephone Number	:	951-235-1070
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	AMIR BADAR
Credential	:	M.D.
Telephone Number	:	951-235-1070

Provider Enumeration Date	:	11/08/2016
Last Update Date	:	11/08/2016

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