Provider Demographics
NPI:1558415802
Name:VISWANATHAN, BHUVANESWARI (MD)
Entity Type:Individual
Prefix:DR
First Name:BHUVANESWARI
Middle Name:
Last Name:VISWANATHAN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1107 COMPASS CT
Mailing Address - Street 2:
Mailing Address - City:NAPERVILLE
Mailing Address - State:IL
Mailing Address - Zip Code:60540-8151
Mailing Address - Country:US
Mailing Address - Phone:312-933-1241
Mailing Address - Fax:630-857-9315
Practice Address - Street 1:5757 NORTH LINCOLN AVE
Practice Address - Street 2:SUITE 27, DIVERSIFIED EMERGENCY SERVICES LLC
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60659
Practice Address - Country:US
Practice Address - Phone:773-728-5133
Practice Address - Fax:773-728-5134
Is Sole Proprietor?:No
Enumeration Date:2007-01-23
Last Update Date:2013-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL36116586207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine