Healthcare Provider Details

I. General information

NPI: 1427234426
Provider Name (Legal Business Name): PARUL BHATT MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/21/2008
Last Update Date: 04/06/2020
Certification Date: 04/06/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4789 ROUTE 71
OSWEGO IL
60543
US

IV. Provider business mailing address

4789 ROUTE 71
OSWEGO IL
60543-7415
US

V. Phone/Fax

Practice location:
  • Phone: 630-898-5969
  • Fax:
Mailing address:
  • Phone: 630-898-5969
  • Fax: 630-898-5837

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number036139748
License Number StateIL

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: