Provider Demographics
NPI:1083969893
Name:ELBISTAN, DILEK (MD)
Entity Type:Individual
Prefix:
First Name:DILEK
Middle Name:
Last Name:ELBISTAN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:DILEK
Other - Middle Name:
Other - Last Name:YARAR
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:500 CHESTNUT ST
Mailing Address - Street 2:
Mailing Address - City:BOWLING GREEN
Mailing Address - State:KY
Mailing Address - Zip Code:42101-1738
Mailing Address - Country:US
Mailing Address - Phone:270-904-2050
Mailing Address - Fax:270-737-9252
Practice Address - Street 1:500 CHESTNUT ST
Practice Address - Street 2:
Practice Address - City:BOWLING GREEN
Practice Address - State:KY
Practice Address - Zip Code:42101-1738
Practice Address - Country:US
Practice Address - Phone:270-904-2050
Practice Address - Fax:270-737-9252
Is Sole Proprietor?:No
Enumeration Date:2012-07-17
Last Update Date:2021-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY51150207R00000X, 207RN0300X
IL125061951390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY7100546110Medicaid