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General NPI Number Information
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NPI Number | 1497739049
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Entity Type | Individual
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Provider Name | MUNISHA MEHRA BHATIA MD
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Gender | Female
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Dates
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Enumeration Date | 12/06/2005
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Last Update Date | 02/07/2025
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Provider Practice Location Address
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Address Line | 1500 W KENNEDY RD
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City | LAKE FOREST
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State | IL
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Zip | 60045-1099
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Country | US
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Telephone | 312-933-6979
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 7010
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City | DEERFIELD
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State | IL
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Zip | 60015-7010
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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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 | 036.102827
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License Number State | IL
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Taxonomy #2
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Taxonomy Code | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | 036102827
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License Number State | IL
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