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NPI Code Detail

MEDICARE: ASHISH C BHATIA M.D.

MEDICARE: ASHISH C BHATIA M.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207N00000XDermatology Physician036111397IL
2207ND0101XMOHS-Micrographic Surgery Physician036111397IL
3207NS0135XProcedural Dermatology Physician036111397IL

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1P00174102OTHERILRR MEDICARE

General Provider Information

NPI Number : 1073595690
Entity Type Code : Individual
Provider Name (Legal Business Name) : ASHISH C BHATIA M.D.
Provider Business Mailing Address
First Line : 550 E DEVON AVE STE 200
Second Line :
City : ITASCA
State : IL
Zip : 60143-2639
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 550 E DEVON AVE STE 200
Second Line :
City : ITASCA
State : IL
Zip : 60143-2639
Country : US
Telephone Number : 864-625-3376
Fax Number : 855-792-2250
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/18/2005
Last Update Date : 02/25/2025

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