Bhanushali, Gautam K
Bhanushali, Gautam K is an sole proprietor health care provider with primary practice located at 2701 W 68Th Street Professional Pavilion 4 South, Chicago IL 60629. He recently has only one registered license in Allopathic & Osteopathic Physicians / Nephrology, which is considered as his primary health care specialty. Bhanushali, Gautam K can be contacted via phone (773) 735-4884.Contact Information
Primary practice address
2701 W 68Th Street Professional Pavilion 4 South
Chicago IL 60629
Phone: (773) 735-4884
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Nephrology | 207RN0300X | 036132193 | Illinois |
Profile Details
| NPI number | 1073829990 |
|---|---|
| LBN Legal business name | Bhanushali, Gautam K |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Aug 30th, 2010 |
| Last updated | Feb 2nd, 2023 - about 3 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1073829990 | NPPES |
| Illinois | Other | 922820024 | MEDICARE |
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