Provider Demographics
NPI:1326266255
Name:BHAKTA MEDICAL ASSOCIATES
Entity Type:Organization
Organization Name:BHAKTA MEDICAL ASSOCIATES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:CHANDU
Authorized Official - Middle Name:D
Authorized Official - Last Name:BHAKTA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:773-585-3131
Mailing Address - Street 1:6283 S ARCHER AVE
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60638-2505
Mailing Address - Country:US
Mailing Address - Phone:773-585-3131
Mailing Address - Fax:773-585-4565
Practice Address - Street 1:6283 S ARCHER AVE
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60638-2505
Practice Address - Country:US
Practice Address - Phone:773-585-3131
Practice Address - Fax:773-585-4565
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-23
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Single Specialty