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Ifath G Bashiruddin, MD
Nephrology Physician in Belleville, Illinois
NPI 1417060534

Ifath G Bashiruddin is a Nephrology Physician based in Saint Charles, IL and is specialized in Nephrology. Ifath G Bashiruddin practices in Belleville, IL and has the professional credentials of MD. The NPI Number for Ifath G Bashiruddin is 1417060534 and holds a License No. 036085731 (Illinois).

The current practice location address for Ifath G Bashiruddin is 4550 Memorial Dr, Belleville, IL and can be reached out via phone at 618-239-9500 and via fax at 618-239-9555.

Location: 4550 Memorial Dr, Belleville, IL, 63303-5497
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1417060534
Provider Name
Ifath G Bashiruddin
Credential
MD
Provider Entity Type
Individual
Gender
Female
Address
4550 Memorial Dr, Belleville, IL, 63303-5497
Phone Number
618-239-9500
Fax Number
618-239-9555
Provider Enumeration Date
08/15/2006
Last Update Date
03/08/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
390007921 01 IL RAILROAD MEDICARE
036085731 05 IL
institution
Provider Business Practice Location Address Details
Address
4550 Memorial Dr
City
Belleville
State
Illinois
Zip
62226-5359
Phone Number
618-239-9500
Fax Number
618-239-9555
person
Provider Business Mailing Address Details
Address
4550 Memorial Dr
City
Belleville
State
Illinois
Zip
62226-5359
Phone Number
618-239-9500
Fax Number
618-239-9555
person
Provider's Taxonomy Details 1
Type
Allopathic & Osteopathic Physicians
Classification
Internal Medicine
Speciality
Nephrology
Taxonomy
207RN0300X
License No.
036085731 (Illinois)
Definition
An internist who treats disorders of the kidney, high blood pressure, fluid and mineral balance and dialysis of body wastes when the kidneys do not function. This specialist consults with surgeons about kidney transplantation.
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