Provider Demographics
NPI:1659694396
Name:NARENDRA D DABHADE MD LTD
Entity Type:Organization
Organization Name:NARENDRA D DABHADE MD LTD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:
Authorized Official - First Name:NARENDRA
Authorized Official - Middle Name:D
Authorized Official - Last Name:DABHADE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:847-455-3302
Mailing Address - Street 1:9722 GRAND AVE
Mailing Address - Street 2:SUITE 1
Mailing Address - City:FRANKLIN PARK
Mailing Address - State:IL
Mailing Address - Zip Code:60131-3357
Mailing Address - Country:US
Mailing Address - Phone:847-455-3302
Mailing Address - Fax:847-455-2539
Practice Address - Street 1:9722 GRAND AVE
Practice Address - Street 2:SUITE 1
Practice Address - City:FRANKLIN PARK
Practice Address - State:IL
Practice Address - Zip Code:60131-3357
Practice Address - Country:US
Practice Address - Phone:847-455-3302
Practice Address - Fax:847-455-2539
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-03-09
Last Update Date:2010-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036041510207R00000X, 207RG0300X, 207RH0000X, 207RX0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
No207RG0300XAllopathic & Osteopathic PhysiciansInternal MedicineGeriatric MedicineGroup - Multi-Specialty
No207RH0000XAllopathic & Osteopathic PhysiciansInternal MedicineHematologyGroup - Multi-Specialty
No207RX0202XAllopathic & Osteopathic PhysiciansInternal MedicineMedical OncologyGroup - Multi-Specialty