Provider Demographics
NPI:1962496034
Name:BHATE, BHARATI D (MD)
Entity Type:Individual
Prefix:
First Name:BHARATI
Middle Name:D
Last Name:BHATE
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 HEALTH SERVICES DR
Mailing Address - Street 2:ILLINOIS REGIONAL CANCER CENTER
Mailing Address - City:DEKALB
Mailing Address - State:IL
Mailing Address - Zip Code:60115
Mailing Address - Country:US
Mailing Address - Phone:815-756-4722
Mailing Address - Fax:815-756-4046
Practice Address - Street 1:10 HEALTH SERVICES DR
Practice Address - Street 2:ILLINOIS REGIONAL CANCER CENTER
Practice Address - City:DEKALB
Practice Address - State:IL
Practice Address - Zip Code:60115
Practice Address - Country:US
Practice Address - Phone:815-756-4722
Practice Address - Fax:815-756-4046
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-09-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL2085R0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0001XAllopathic & Osteopathic PhysiciansRadiologyRadiation Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
210339OtherMEDICARE PROVIDER NUMBER
210339OtherMEDICARE PROVIDER NUMBER
K12337Medicare ID - Type Unspecified