Healthcare Provider Details

I. General information

NPI: 1750677043
Provider Name (Legal Business Name): BAQIR LAKHANI DO
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/24/2011
Last Update Date: 02/10/2022
Certification Date: 02/10/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

800 BIESTERFIELD RD STE 303
ELK GROVE VILLAGE IL
60007-3378
US

IV. Provider business mailing address

800 BIESTERFIELD RD STE 303
ELK GROVE VILLAGE IL
60007-3378
US

V. Phone/Fax

Practice location:
  • Phone: 847-981-3680
  • Fax:
Mailing address:
  • Phone: 847-981-3680
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number125060222
License Number StateIL
# 2
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number02005046A
License Number StateIN
# 3
Primary TaxonomyN
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License Number02005046A
License Number StateIN
# 4
Primary TaxonomyN
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License Number036133958
License Number StateIL
# 5
Primary TaxonomyN
Taxonomy Code207UN0901X
TaxonomyNuclear Cardiology Physician
License Number036133958
License Number StateIL
# 6
Primary TaxonomyN
Taxonomy Code207RA0001X
TaxonomyAdvanced Heart Failure and Transplant Cardiology Physician
License Number81272
License Number StateGA
# 7
Primary TaxonomyY
Taxonomy Code207RA0001X
TaxonomyAdvanced Heart Failure and Transplant Cardiology Physician
License Number036133958
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: