Provider Demographics
NPI:1447292024
Name:BASEER, RAZIA SULTANA (MD)
Entity type:Individual
Prefix:MRS
First Name:RAZIA
Middle Name:SULTANA
Last Name:BASEER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:324 TRINITY LANE
Mailing Address - Street 2:
Mailing Address - City:OAKBROOK
Mailing Address - State:IL
Mailing Address - Zip Code:60523
Mailing Address - Country:US
Mailing Address - Phone:630-740-1522
Mailing Address - Fax:
Practice Address - Street 1:4018 W 127TH ST
Practice Address - Street 2:
Practice Address - City:ALSIP
Practice Address - State:IL
Practice Address - Zip Code:60803-1923
Practice Address - Country:US
Practice Address - Phone:708-489-2123
Practice Address - Fax:708-489-5294
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-11
Last Update Date:2012-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036065709208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
D93907Medicare UPIN