MEDICARE: DR. BASHEERUDDIN FAROOKI MD

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	207RC0200X	Critical Care Medicine (Internal Medicine) Physician	036106493	IL
2	207R00000X	Internal Medicine Physician	036106493	IL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	0-583-705-9	OTHER		ECFMG
3	336-067287	OTHER	IL	CONTROLLED SUBSTANCE

General Provider Information

NPI Number	:	1720038979
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. BASHEERUDDIN FAROOKI MD

Provider Business Mailing Address
First Line	:	1721 YORK RD
Second Line	:
City	:	OAK BROOK
State	:	IL
Zip	:	60523-1528
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	5140 N CALIFORNIA AVE
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60625-3645
Country	:	US
Telephone Number	:	773-878-8200
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/10/2006
Last Update Date	:	05/14/2026

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