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NPI Code Detail

MEDICARE: BETHESDA MEDICARE SERVICES LTD

MEDICARE: BETHESDA MEDICARE SERVICES LTD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207R00000XInternal Medicine Physician

General Provider Information

NPI Number : 1487990495
Entity Type Code : Organization
Provider Name (Legal Business Name) : BETHESDA MEDICARE SERVICES LTD
Provider Business Mailing Address
First Line : 990 GRAND CANYON PKWY
Second Line : SUITE 418
City : HOFFMAN ESTATES
State : IL
Zip : 60169-1739
Country : US
Telephone Number : 331-472-8802
Fax Number : 331-472-8803
Provider Business Practice Location Address
First Line : 990 GRAND CANYON PKWY
Second Line : SUITE 418
City : HOFFMAN ESTATES
State : IL
Zip : 60169-1737
Country : US
Telephone Number : 331-472-8802
Fax Number : 331-472-8803
Authorized Official
Title or Position : OWNER
Name : MEENA KRISHNA
Credential : MD
Telephone Number : 331-472-8802
Provider Enumeration Date : 12/19/2012
Last Update Date : 10/02/2013

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Directions to “BETHESDA MEDICARE SERVICES LTD ” Practice Location

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