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General NPI Number Information
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NPI Number | 1568608180
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Entity Type | Individual
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Provider Name | AJAY BHATIA M.D.
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Gender | Male
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Dates
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Enumeration Date | 01/02/2009
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Last Update Date | 04/25/2019
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Provider Practice Location Address
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Address Line | 2222 W DIVISION ST STE 230
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City | CHICAGO
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State | IL
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Zip | 60622
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Country | US
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Telephone | 312-720-0851
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Fax |
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Provider Business Mailing Address
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Address Line | 2222 W DIVISION ST STE 230
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City | CHICAGO
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State | IL
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Zip | 60622-2989
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Country | US
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Telephone | 312-720-0851
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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 | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 036.123602
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License Number State | IL
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