MEDICARE: DR. SEEMA WIDHANI 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
1	207R00000X	Internal Medicine Physician		IL

General Provider Information

NPI Number	:	1811032469
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. SEEMA WIDHANI BHATIA M.D.

Provider Business Mailing Address
First Line	:	10 W WESTLEIGH RD
Second Line	:
City	:	LAKE FOREST
State	:	IL
Zip	:	60045-2802
Country	:	US
Telephone Number	:	847-910-0298
Fax Number	:	847-283-0474

Provider Business Practice Location Address
First Line	:	10 W WESTLEIGH RD
Second Line	:
City	:	LAKE FOREST
State	:	IL
Zip	:	60045-2802
Country	:	US
Telephone Number	:	847-910-0298
Fax Number	:	847-283-0474

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

Provider Enumeration Date	:	02/21/2007
Last Update Date	:	07/08/2007

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