Basic Information
| Provider Information | |||||||||
| NPI: | 1083728398 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | BADRI | ||||||||
| FirstName: | SHEILA | ||||||||
| MiddleName: | MINA | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1625 N CLEVELAND AVE | ||||||||
| Address2: | |||||||||
| City: | CHICAGO | ||||||||
| State: | IL | ||||||||
| PostalCode: | 606145601 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3128644585 | ||||||||
| FaxNumber: | 3128649496 | ||||||||
| Practice Location | |||||||||
| Address1: | 1901 W HARRISON ST | ||||||||
| Address2: | |||||||||
| City: | CHICAGO | ||||||||
| State: | IL | ||||||||
| PostalCode: | 606123714 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3128644585 | ||||||||
| FaxNumber: | 3128649496 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 08/17/2006 | ||||||||
| LastUpdateDate: | 04/21/2021 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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| NPICertificationDate: | 04/21/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207R00000X | 036-097552 | IL | N | Allopathic & Osteopathic Physicians | Internal Medicine | 207RI0200X | 036-097552 | IL | Y | Allopathic & Osteopathic Physicians | Internal Medicine | Infectious Disease |
No ID Information.