MEDICARE: DR. BHARATHI SWAMINATHAN 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
1	208100000X	Physical Medicine & Rehabilitation Physician	036107247	IL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1336105154
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. BHARATHI SWAMINATHAN M.D.

Provider Business Mailing Address
First Line	:	1. S.GREENLEAF STREET
Second Line	:	SUITE D
City	:	GURNEE
State	:	IL
Zip	:	60031
Country	:	US
Telephone Number	:	847-918-1442
Fax Number	:	847-327-3882

Provider Business Practice Location Address
First Line	:	1. S GREENLEAF ST
Second Line	:	STE D
City	:	GURNEE
State	:	IL
Zip	:	60031-5709
Country	:	US
Telephone Number	:	847-918-1442
Fax Number	:	847-327-3882

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/21/2006
Last Update Date	:	09/10/2012

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