Healthcare Provider Details

I. General information

NPI: 1962679852
Provider Name (Legal Business Name): ARMUGHAN Z BANGASH M.D
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/11/2008
Last Update Date: 08/24/2026
Certification Date: 08/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

100 BATSON CT STE 106
NEW LENOX IL
60451-1567
US

IV. Provider business mailing address

100 BATSON CT STE 106
NEW LENOX IL
60451-1567
US

V. Phone/Fax

Practice location:
  • Phone: 815-463-9747
  • Fax: 815-463-9749
Mailing address:
  • Phone: 815-463-9747
  • Fax: 815-463-9749

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number036.134415
License Number StateIL
# 2
Primary TaxonomyN
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License Number036.134415
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: