Provider Demographics
NPI:1891984019
Name:AMARJIT S BHASIN MD LTD
Entity Type:Organization
Organization Name:AMARJIT S BHASIN MD LTD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:NEUROLOGIST PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:AMARJIT
Authorized Official - Middle Name:SINGH
Authorized Official - Last Name:BHASIN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:708-799-3044
Mailing Address - Street 1:17680 KEDZIE AVE
Mailing Address - Street 2:SUITE 105
Mailing Address - City:HAZEL CREST
Mailing Address - State:IL
Mailing Address - Zip Code:60429
Mailing Address - Country:US
Mailing Address - Phone:708-799-3044
Mailing Address - Fax:708-799-2441
Practice Address - Street 1:17680 KEDZIE AVE
Practice Address - Street 2:SUITE 105
Practice Address - City:HAZEL CREST
Practice Address - State:IL
Practice Address - Zip Code:60429
Practice Address - Country:US
Practice Address - Phone:708-799-3044
Practice Address - Fax:708-799-2441
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-10-24
Last Update Date:2007-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL2084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN100273770Medicaid
IL036063300Medicaid
IL036063300Medicaid
IL681101Medicare PIN