Organization Active NPI

Bushra Haider MD LLC

  • Family Medicine Physician
  • Oak Brook, IL
National Provider Identifier
1174092993
Registry record updated Mar 29, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
BUSHRA HAIDER MD LLC
Practice address
2001 Midwest Rd Ste 110
Oak Brook, IL 60523-4300
Phone
(630) 360-2646
NPI assigned
Nov 21, 2018
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 29, 2019

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

Authorized official

Name
Bushra Haider, MD
Title
President
Phone
(630) 932-8000

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207Q00000X Primary

Addresses

Primary practice location

2001 Midwest Rd Ste 110
Oak Brook, IL 60523-4300

Mailing address

6103 Tyrnbury Dr
Lisle, IL 60532-3200
Phone (412) 979-3470

Other practice location 1

1S161 Summit Ave
Oakbrook Terrace, IL 60181-3904
Phone (630) 932-8000

National Provider Directory

National Provider Directory

Locations

2001 Midwest Rd
Ste 105
Oak Brook, IL 60523

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1542758400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1553817600000",
    "number": "1174092993",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6103 TYRNBURY DR",
            "city": "LISLE",
            "state": "IL",
            "postal_code": "605323200",
            "telephone_number": "412-979-3470",
            "fax_number": "630-932-8025"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2001 MIDWEST RD STE 110",
            "city": "OAK BROOK",
            "state": "IL",
            "postal_code": "605234300",
            "telephone_number": "630-360-2646"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1S161 Summit Ave",
            "address_purpose": "LOCATION",
            "city": "Oakbrook Terrace",
            "state": "IL",
            "postal_code": "601813904",
            "country_code": "US",
            "telephone_number": "630-932-8000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "BUSHRA HAIDER MD LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-11-21",
        "last_updated": "2019-03-29",
        "status": "A",
        "authorized_official_last_name": "HAIDER",
        "authorized_official_first_name": "BUSHRA",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "630-932-8000",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Oak Brook, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 29, 2019; 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.