MEDICARE: BULBUL BAHUGUNA

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
1	2084N0400X	Neurology Physician	036076001	IL

General Provider Information

NPI Number	:	1629342472
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BULBUL BAHUGUNA

Provider Business Mailing Address
First Line	:	332 SKOKIE VALLEY RD
Second Line	:	SUITE 225A
City	:	HIGHLAND PARK
State	:	IL
Zip	:	60035-4415
Country	:	US
Telephone Number	:	773-907-2831
Fax Number	:	773-751-2250

Provider Business Practice Location Address
First Line	:	332 SKOKIE VALLEY RD
Second Line	:	SUITE 225A
City	:	HIGHLAND PARK
State	:	IL
Zip	:	60035-4415
Country	:	US
Telephone Number	:	773-907-2831
Fax Number	:	773-751-2250

Authorized Official
Title or Position	:	PRES
Name	:	DR. BULBUL BAHUGUNA
Credential	:	MD
Telephone Number	:	773-907-2831

Provider Enumeration Date	:	02/25/2012
Last Update Date	:	02/25/2012

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Directions to “BULBUL BAHUGUNA ” Practice Location

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