Provider Demographics
NPI:1811032469
Name:BHATIA, SEEMA WIDHANI (MD)
Entity Type:Individual
Prefix:DR
First Name:SEEMA
Middle Name:WIDHANI
Last Name:BHATIA
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 1:10 W WESTLEIGH RD
Mailing Address - Street 2:
Mailing Address - City:LAKE FOREST
Mailing Address - State:IL
Mailing Address - Zip Code:60045-2802
Mailing Address - Country:US
Mailing Address - Phone:847-910-0298
Mailing Address - Fax:847-283-0474
Practice Address - Street 1:10 W WESTLEIGH RD
Practice Address - Street 2:
Practice Address - City:LAKE FOREST
Practice Address - State:IL
Practice Address - Zip Code:60045-2802
Practice Address - Country:US
Practice Address - Phone:847-910-0298
Practice Address - Fax:847-283-0474
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
ILD16602Medicare UPIN