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General NPI Number Information
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NPI Number | 1336648799
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Entity Type | Organization
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Legal Business Name | ASHOK H BHASKAR MD LTD
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Dates
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Enumeration Date | 02/12/2018
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Last Update Date | 02/12/2018
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Provider Practice Location Address
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Address Line | 16001 EXECUTIVE DR
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City | CREST HILL
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State | IL
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Zip | 60403-0500
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Country | US
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Telephone | 815-744-1600
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Fax | 815-838-0556
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Provider Business Mailing Address
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Address Line | 16001 EXECUTIVE DR
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City | CREST HILL
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State | IL
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Zip | 60403-0500
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Country | US
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Telephone | 815-744-1600
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Fax | 815-838-0556
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. ASHOK H BHASKAR
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Credential | MD
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Telephone | 630-904-8425
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | 036093909
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License Number State | IL
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