Provider Demographics
NPI:1336648799
Name:ASHOK H BHASKAR MD LTD
Entity Type:Organization
Organization Name:ASHOK H BHASKAR MD LTD
Other - Org Name:COMMUNITY PEDIATRICS LTD
Other - Org Type:Other Name
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ASHOK
Authorized Official - Middle Name:H
Authorized Official - Last Name:BHASKAR
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:630-904-8425
Mailing Address - Street 1:16001 EXECUTIVE DR
Mailing Address - Street 2:
Mailing Address - City:CREST HILL
Mailing Address - State:IL
Mailing Address - Zip Code:60403-0500
Mailing Address - Country:US
Mailing Address - Phone:815-744-1600
Mailing Address - Fax:815-838-0556
Practice Address - Street 1:16001 EXECUTIVE DR
Practice Address - Street 2:
Practice Address - City:CREST HILL
Practice Address - State:IL
Practice Address - Zip Code:60403-0500
Practice Address - Country:US
Practice Address - Phone:815-744-1600
Practice Address - Fax:815-838-0556
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-02-12
Last Update Date:2018-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036093909208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Single Specialty