| Ifath G Bashiruddin, MD | |
|
4550 Memorial Dr, Suite 360, Belleville, IL 62226-5359 | |
| (618) 239-9500 | |
| (618) 239-9555 |
| Full Name | Ifath G Bashiruddin |
|---|---|
| Gender | Female |
| Speciality | Nephrology |
| Experience | 49 Years |
| Location | 4550 Memorial Dr, Belleville, Illinois |
| Accepts Medicare Assignments | Yes. She accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1417060534 | NPI | - | NPPES |
| 390007921 | Other | IL | RAILROAD MEDICARE |
| 036085731 | Medicaid | IL |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207RN0300X | Internal Medicine - Nephrology | 036085731 (Illinois) | Primary |
| Facility Name | Location | Facility Type |
|---|---|---|
| Fmc - Regency Park | O fallon, IL | Dialysis facility |
| Davita - Metro East Dialysis | Belleville, IL | Dialysis facility |
| Davita - Shiloh Dialysis | Belleville, IL | Dialysis facility |
| Memorial Hospital | Belleville, IL | Hospital |
| Hshs St Elizabeth's Hospital | O fallon, IL | Hospital |
| St Josephs Hospital | Breese, IL | Hospital |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Rashid A Dalal Md Pc | 2163459348 | 5 |
| Entity Name | Rashid A Dalal Md Pc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1053390484 PECOS PAC ID: 2163459348 Enrollment ID: O20050719001076 |
| Mailing Address | Practice Location Address |
|---|---|
| Ifath G Bashiruddin, MD 7 Beaver Creek Ct, Saint Charles, MO 63303-5497 Ph: (618) 239-9500 | Ifath G Bashiruddin, MD 4550 Memorial Dr, Suite 360, Belleville, IL 62226-5359 Ph: (618) 239-9500 |
Dr. Dennis P Larson, M.D. Nephrology Medicare: Not Enrolled in Medicare Practice Location: 509 E Waters Edge Dr, Belleville, IL 62221 Phone: 618-235-1510 Fax: 618-235-1502 | |
Kathleen K Fournier, MD Nephrology Medicare: Not Enrolled in Medicare Practice Location: 4600 Memorial Dr, Suite 100, Belleville, IL 62226 Phone: 618-222-9999 Fax: 618-222-9337 | |
Eldon Trame, M.D. Nephrology Medicare: Not Enrolled in Medicare Practice Location: 2900 Frank Scott Pkwy W, Suite 904, Belleville, IL 62223 Phone: 618-234-0640 Fax: 314-851-4475 | |
Dr. Vibhu Dhawan, MD Nephrology Medicare: Accepting Medicare Assignments Practice Location: 4500 Memorial Dr, Belleville, IL 62226 Phone: 618-257-6220 | |
Anand P. Patel, MD Nephrology Medicare: Accepting Medicare Assignments Practice Location: 4500 Memorial Dr, Belleville, IL 62226 Phone: 618-257-6220 | |
Kashif Shahzad Bhutto, MD Nephrology Medicare: Accepting Medicare Assignments Practice Location: 4600 Memorial Dr Ste 200, Belleville, IL 62226 Phone: 618-233-2220 Fax: 618-233-2555 | |
Dr. David Nelson Pfohl, MD, FACP, GAQ Nephrology Medicare: Not Enrolled in Medicare Practice Location: 45 Pebble Hill Dr, Belleville, IL 62223 Phone: 618-604-6518 |