Provider Demographics
NPI:1346420890
Name:JAVED I. BANGASH, M.D.S.C
Entity Type:Organization
Organization Name:JAVED I. BANGASH, M.D.S.C
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JAVED
Authorized Official - Middle Name:IQBAL
Authorized Official - Last Name:BANGASH
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:847-742-9698
Mailing Address - Street 1:2050 LARKIN AVE
Mailing Address - Street 2:STE 101
Mailing Address - City:ELGIN
Mailing Address - State:IL
Mailing Address - Zip Code:60123-4405
Mailing Address - Country:US
Mailing Address - Phone:847-742-9698
Mailing Address - Fax:847-742-9743
Practice Address - Street 1:2050 LARKIN AVE
Practice Address - Street 2:STE 101
Practice Address - City:ELGIN
Practice Address - State:IL
Practice Address - Zip Code:60123-4405
Practice Address - Country:US
Practice Address - Phone:847-742-9698
Practice Address - Fax:847-742-9743
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-11-13
Last Update Date:2007-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Single Specialty