Basel Al-Aswad M D S C

Primary specialty

Orthopaedic Surgery PhysicianTaxonomy code 207X00000X

License

036048539 Issued in IL

Legal business name

BASEL AL-ASWAD M D S C

Practice address

2850 W 95TH St
Suite 406
Evergreen Park, IL 60805-2790

Phone

(708) 499-4844

Fax

(708) 499-0731

NPI assigned

Jan 30, 2007

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Basel I Al-Aswad, MD

Title

President

Phone

(708) 499-4844

Specialties & licenses 1

Addresses

Other identifiers 3

Other names 1

• Evergreen Orthopedics SC Doing business as

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1170115200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1678147200000",
    "number": "1083751150",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2850 W 95TH ST",
            "address_2": "SUITE 406",
            "city": "EVERGREEN PARK",
            "state": "IL",
            "postal_code": "608052790",
            "telephone_number": "708-499-4844",
            "fax_number": "708-499-0731"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2850 W 95TH ST",
            "address_2": "SUITE 406",
            "city": "EVERGREEN PARK",
            "state": "IL",
            "postal_code": "608052790",
            "telephone_number": "708-499-4844",
            "fax_number": "708-499-0731"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BASEL AL-ASWAD M D S C",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-30",
        "last_updated": "2023-03-07",
        "status": "A",
        "authorized_official_last_name": "AL-ASWAD",
        "authorized_official_first_name": "BASEL",
        "authorized_official_middle_name": "I",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "708-499-4844",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Orthopaedic Surgery",
            "state": "IL",
            "license": "036048539",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE NUMBER",
            "identifier": "036048539",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS PROVIDER #",
            "identifier": "31602972",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE ID-RAILROAD",
            "identifier": "CG7199",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Evergreen Orthopedics SC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Orthopaedic Surgery Physician in Evergreen Park, IL
• Providers in Evergreen Park, IL by specialty
• Orthopaedic Surgery Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.