Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207W00000X | Ophthalmologist | 036126605 | IL |
N | 207W00000X | Ophthalmologist | 2060-850 | WI |
NPI | 1003034927 |
---|---|
Provider Name | Dr. Sandeep K Bhatia |
First Address | Chicago, IL 60605 |
Second Address | Olympia Fields, IL 60461-1173 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 23/04/2007 |
Last Update Date | 27/12/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
036126605 | (05) | IL |