Provider Demographics
NPI:1134398506
Name:BHOWMICK, NABANITA (MD)
Entity type:Individual
Prefix:DR
First Name:NABANITA
Middle Name:
Last Name:BHOWMICK
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:NABANITA
Other - Middle Name:
Other - Last Name:DAM
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:370 SUMMIT ST
Mailing Address - Street 2:
Mailing Address - City:ELGIN
Mailing Address - State:IL
Mailing Address - Zip Code:60120-3843
Mailing Address - Country:US
Mailing Address - Phone:847-608-6323
Mailing Address - Fax:847-608-6775
Practice Address - Street 1:370 SUMMIT ST
Practice Address - Street 2:
Practice Address - City:ELGIN
Practice Address - State:IL
Practice Address - Zip Code:60120-3843
Practice Address - Country:US
Practice Address - Phone:847-608-6323
Practice Address - Fax:847-608-6775
Is Sole Proprietor?:No
Enumeration Date:2008-02-29
Last Update Date:2020-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036117898207QA0401X, 207QA0505X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207QA0505XAllopathic & Osteopathic PhysiciansFamily MedicineAdult Medicine
No207QA0401XAllopathic & Osteopathic PhysiciansFamily MedicineAddiction Medicine