MEDICARE: DR. BRETT BATCHELOR 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	2085R0202X	Diagnostic Radiology Physician	01076335A	IN
2	2085R0202X	Diagnostic Radiology Physician	036142469	IL

General Provider Information

NPI Number	:	1992060073
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. BRETT BATCHELOR M.D.

Provider Business Mailing Address
First Line	:	680 N. LAKE SHORE DRIVE
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60611-2987
Country	:	US
Telephone Number	:	312-695-6868
Fax Number	:

Provider Business Practice Location Address
First Line	:	676 NORTH ST. CLAIR STREET SUITE 800
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60611-5149
Country	:	US
Telephone Number	:	312-695-6868
Fax Number	:	502-544-7680

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

Provider Enumeration Date	:	07/05/2012
Last Update Date	:	07/21/2022

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