Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225X00000X | Occupational Therapist | 056009928 | IL |
N | 225XP0200X | Occupational Therapist - Pediatrics | 056009928 | IL |
NPI | 1023473477 |
---|---|
Provider Name | Bhumi Bhatt |
First Address | Aurora, IL 60502-8665 |
Second Address | Libertyville, IL 60048-3254 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 29/12/2015 |
Last Update Date | 29/12/2015 |