Basic Information
| Provider Information | |||||||||
| NPI: | 1871769331 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | BADRUDDIN | ||||||||
| FirstName: | AAMIR | ||||||||
| MiddleName: | |||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 301 N. MADISON ST. | ||||||||
| Address2: | SUITE 300 | ||||||||
| City: | JOLIET | ||||||||
| State: | IL | ||||||||
| PostalCode: | 60435 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8157254367 | ||||||||
| FaxNumber: | 8157254863 | ||||||||
| Practice Location | |||||||||
| Address1: | 901 MACARTHUR BLVD | ||||||||
| Address2: | |||||||||
| City: | MUNSTER | ||||||||
| State: | IN | ||||||||
| PostalCode: | 463212901 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2198361600 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 05/05/2008 | ||||||||
| LastUpdateDate: | 10/14/2022 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 10/14/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 2084N0400X | 036120881 | IL | N | Allopathic & Osteopathic Physicians | Psychiatry & Neurology | Neurology | 207T00000X | 036.120881 | IL | N | Allopathic & Osteopathic Physicians | Neurological Surgery | 2084V0102X | 036.120881 | IL | N | Allopathic & Osteopathic Physicians | Psychiatry & Neurology | Vascular Neurology | 2084V0102X | 01081926A | IN | N | Allopathic & Osteopathic Physicians | Psychiatry & Neurology | Vascular Neurology | 2085N0700X | 036.120881 | IL | N | Allopathic & Osteopathic Physicians | Radiology | Neuroradiology | 2084A2900X | 01081926A | IN | Y |
ID Information
| ID | Type | State | Issuer | Description | 300024700 | 05 | IN | MEDICAID |