Al-Basha, Maria I

Al-Basha, Maria I is an sole proprietor health care provider with primary practice located at 1639 N Alpine Rd , Rockford IL 61107-1449. She recently has only one registered license in Allopathic & Osteopathic Physicians / Dermatology, which is considered as her primary health care specialty. Al-Basha, Maria I can be contacted via phone (815) 229-9333.

Contact Information

Primary practice address
1639 N Alpine Rd Rockford IL 61107-1449
Fax:
Website:

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Dermatology 207N00000X 036079495 Illinois

Profile Details

NPI number 1922199967
LBN Legal business name Al-Basha, Maria I
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Sep 27th, 2006
Last updated Jun 21st, 2018 - about 6 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1922199967 NPPES
Illinois MEDICAID 036079495

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