Ifath G. Bashiruddin M.D.S.C.

Primary specialty

SpecialistTaxonomy code 174400000X

Legal business name

IFATH G. BASHIRUDDIN M.D.S.C.

Practice address

4550 Memorial Dr
Suite 410
Belleville, IL 62226-5359

Phone

(618) 234-8246

Fax

(618) 234-8271

NPI assigned

Oct 22, 2007

Organization subpart

No

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

Authorized official

Name

Mr. Deborah Haake

Title

Business Manager

Phone

(618) 234-8246

Specialties & licenses 1

Addresses

Practitioners 1

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

• Robert John Haake, D.O.

  • Internal Medicine Physician
  • Eagle, ID
  • NPI 1295747046
  NPD (past)

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

{
    "created_epoch": "1193011200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1194220800000",
    "number": "1821287293",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3415 SALUKI WOODS RD",
            "city": "BELLEVILLE",
            "state": "IL",
            "postal_code": "622237017",
            "telephone_number": "618-234-8246",
            "fax_number": "618-234-8271"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4550 MEMORIAL DR",
            "address_2": "SUITE 410",
            "city": "BELLEVILLE",
            "state": "IL",
            "postal_code": "622265359",
            "telephone_number": "618-234-8246",
            "fax_number": "618-234-8271"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "IFATH G. BASHIRUDDIN M.D.S.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-10-22",
        "last_updated": "2007-11-05",
        "status": "A",
        "authorized_official_last_name": "HAAKE",
        "authorized_official_first_name": "DEBORAH",
        "authorized_official_title_or_position": "BUSINESS MANAGER",
        "authorized_official_telephone_number": "618-234-8246",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Laura Hutcheson I
• Mary Hutchinson, SLP
• Courtney L Hutkowski, ACNP
• HW Holdings
• Idjj SD#428
• Illinois Associates in Psychiatry PC
• Infectious Disease Consultants
• Infinity-Meds LLP
• Innovative Eye Care Solutions, LTD.
• Inspire Community Homes

• Specialist in Belleville, IL
• Providers in Belleville, IL by specialty
• Specialist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 5, 2007; 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.