MEDICARE: DR. ASHOK H BHASKAR MD

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	2080A0000X	Pediatric Adolescent Medicine Physician		IL

General Provider Information

NPI Number	:	1558402958
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ASHOK H BHASKAR MD

Provider Business Mailing Address
First Line	:	1120 CORDULA CIR
Second Line	:
City	:	NAPERVILLE
State	:	IL
Zip	:	60564-4165
Country	:	US
Telephone Number	:	630-904-8425
Fax Number	:

Provider Business Practice Location Address
First Line	:	2250 WEBER RD
Second Line	:
City	:	CREST HILL
State	:	IL
Zip	:	60435-0928
Country	:	US
Telephone Number	:	815-744-1600
Fax Number	:	815-744-8896

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

Provider Enumeration Date	:	02/09/2007
Last Update Date	:	07/08/2007

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