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General NPI Number Information
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NPI Number | 1730495441
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Entity Type | Individual
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Provider Name | DR. SUDEEP HARI BHABAD
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Gender | Male
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Dates
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Enumeration Date | 08/19/2010
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Last Update Date | 04/04/2025
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Provider Practice Location Address
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Address Line | 1653 W CONGRESS PKWY # 181
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City | CHICAGO
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State | IL
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Zip | 60612-3833
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Country | US
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Telephone | 312-942-5000
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Fax |
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Provider Business Mailing Address
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Address Line | 233 E 13TH ST APT 2001
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City | CHICAGO
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State | IL
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Zip | 60605-3259
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Country | US
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Telephone | 312-813-2493
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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 | 2085R0202X
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Taxonomy Name | Diagnostic Radiology Physician
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License Number | 036130789
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License Number State | IL
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Taxonomy #2
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Taxonomy Code | 2085N0700X
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Taxonomy Name | Neuroradiology Physician
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License Number | 036130789
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License Number State | IL
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