Bhagavan, M S

Bhagavan, M S is an sole proprietor health care provider with primary practice located at 645 S Central Ave , Chicago IL 60644. He recently has only one registered license in Allopathic & Osteopathic Physicians / Internal Medicine, which is considered as his primary health care specialty. Bhagavan, M S can be contacted via phone (708) 275-7458.

Contact Information

Primary practice address
645 S Central Ave Chicago IL 60644
Phone: (708) 275-7458
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Internal Medicine 207R00000X 036-094099 Illinois

Profile Details

NPI number 1174512917
LBN Legal business name Bhagavan, M S
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Oct 14th, 2005
Last updated Mar 6th, 2017 - about 9 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1174512917 NPPES
Illinois MEDICAID 036-094099-1

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