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NPI Code Detail

MEDICARE: DR. BHARTI R PATIL D.D.S.

MEDICARE: DR. BHARTI R PATIL D.D.S.
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
11223G0001XGeneral Practice DentistryIL

General Provider Information

NPI Number : 1346395456
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. BHARTI R PATIL D.D.S.
Provider Business Mailing Address
First Line : 701 CREEKSIDE CIR
Second Line :
City : GURNEE
State : IL
Zip : 60031-2060
Country : US
Telephone Number : 847-680-1299
Fax Number :
Provider Business Practice Location Address
First Line : 2127 GREEN BAY RD
Second Line :
City : NORTH CHICAGO
State : IL
Zip : 60064-2801
Country : US
Telephone Number : 847-689-3800
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/25/2007
Last Update Date : 07/08/2007

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