Healthcare Provider Details

I. General information

NPI: 1477992899
Provider Name (Legal Business Name): MAYANK BHAYANA M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/19/2013
Last Update Date: 10/13/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

700 E OGDEN AVE SUITE 202
WESTMONT IL
60559-5569
US

IV. Provider business mailing address

700 E OGDEN AVE SUITE 202
WESTMONT IL
60559-5569
US

V. Phone/Fax

Practice location:
  • Phone: 630-528-3215
  • Fax:
Mailing address:
  • Phone: 630-528-3215
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License Number036139166
License Number StateIL
# 2
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number036139166
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: