Healthcare Provider Details

I. General information

NPI: 1396788006
Provider Name (Legal Business Name): BIKRAM SINGH DHILLON M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/13/2006
Last Update Date: 01/26/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

836 W WELLINGTON AVE ADVOCATE ILLINOIS MASONIC MEDICAL CENTER, EMERGENCY MED
CHICAGO IL
60657-5147
US

IV. Provider business mailing address

432 JASON CT
SCHAUMBURG IL
60173-2075
US

V. Phone/Fax

Practice location:
  • Phone: 773-296-7054
  • Fax: 773-296-7818
Mailing address:
  • Phone: 847-995-0344
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License Number036-081373
License Number StateIL
# 2
Primary TaxonomyN
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License Number51463-20
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: