Mirza R Baig
Individual provider Active NPI Driver · Chicago, IL
NPI 1487076766 · NPPES record last updated Jan 6, 2014
Key facts
- NPI
- 1487076766
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Driver 172A00000X
- License
- B20055679313 (IL)
- Practice address
- 1519 W Granville Ave
Apt 1B
Chicago, IL 60660-1811 - Phone
- (773) 690-2589
- NPI assigned
- Jan 6, 2014
- Sex
- Male
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| B20055679313 | IL | MD | Driver |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Driver | 172A00000X | B20055679313 | IL | Yes |
Addresses
Primary practice location
1519 W Granville Ave
Apt 1B
Chicago, IL 60660-1811
Mailing address
1519 W Granville Ave
Apt 1B
Chicago, IL 60660-1811
Phone (773) 690-2589
Other providers in Chicago, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 6, 2014. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.