Healthcare Provider Details

I. General information

NPI: 1366920795
Provider Name (Legal Business Name): AKASH BHATIA
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/28/2018
Last Update Date: 10/21/2025
Certification Date: 10/21/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1316 SHERMAN AVE
EVANSTON IL
60201-4361
US

IV. Provider business mailing address

2130 GREEN BAY RD
EVANSTON IL
60201-3026
US

V. Phone/Fax

Practice location:
  • Phone: 847-425-9708
  • Fax:
Mailing address:
  • Phone: 847-213-0749
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number180.013448
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: