MEDICARE: DR. KHUSHBU BAROT

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	122300000X	Dentist	019030684	IL

General Provider Information

NPI Number	:	1427407568
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. KHUSHBU BAROT

Provider Business Mailing Address
First Line	:	563 SOMERSET LN APT 7
Second Line	:
City	:	CRYSTAL LAKE
State	:	IL
Zip	:	60014-7756
Country	:	US
Telephone Number	:	815-575-0861
Fax Number	:

Provider Business Practice Location Address
First Line	:	1768 W ALGONQUIN RD
Second Line	:
City	:	ARLINGTON HEIGHTS
State	:	IL
Zip	:	60005-3405
Country	:	US
Telephone Number	:	331-234-3000
Fax Number	:

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

Provider Enumeration Date	:	06/09/2016
Last Update Date	:	05/01/2018

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