Healthcare Provider Details

I. General information

NPI: 1063501906
Provider Name (Legal Business Name): MANISH BHAGWAN SAWLANI M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/11/2006
Last Update Date: 05/11/2021
Certification Date: 05/11/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2500 W HIGGINS RD SUITE 430
HOFFMAN ESTATES IL
60195-5220
US

IV. Provider business mailing address

31 REGENT DR
OAK BROOK IL
60523-1744
US

V. Phone/Fax

Practice location:
  • Phone: 847-882-0988
  • Fax: 847-882-1282
Mailing address:
  • Phone: 630-654-2680
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number036095781
License Number StateIL
# 2
Primary TaxonomyN
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License Number036095781
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: