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NPI Code Detail

MEDICARE: AJAY BADDI M.D.

MEDICARE: AJAY BADDI M.D.
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
1207RC0000XCardiovascular Disease Physician036097688IL

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
11602375OTHERILBSBC
21487951711OTHERILNPI GROUP PRACTICE

General Provider Information

NPI Number : 1831145804
Entity Type Code : Individual
Provider Name (Legal Business Name) : AJAY BADDI M.D.
Provider Business Mailing Address
First Line : 29373 NETWORK PL
Second Line :
City : CHICAGO
State : IL
Zip : 60673-3014
Country : US
Telephone Number : 847-390-5900
Fax Number :
Provider Business Practice Location Address
First Line : 3134 N CLARK ST
Second Line :
City : CHICAGO
State : IL
Zip : 60657-4414
Country : US
Telephone Number : 773-880-9722
Fax Number : 312-766-4917
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/25/2006
Last Update Date : 09/27/2022

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