Provider Demographics
NPI:1396321121
Name:BAMRA, AMAR
Entity type:Individual
Prefix:
First Name:AMAR
Middle Name:
Last Name:BAMRA
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:120 W GOLF RD STE 100C
Mailing Address - Street 2:
Mailing Address - City:SCHAUMBURG
Mailing Address - State:IL
Mailing Address - Zip Code:60195-3618
Mailing Address - Country:US
Mailing Address - Phone:630-534-0303
Mailing Address - Fax:
Practice Address - Street 1:120 W GOLF RD STE 100C
Practice Address - Street 2:
Practice Address - City:SCHAUMBURG
Practice Address - State:IL
Practice Address - Zip Code:60195-3618
Practice Address - Country:US
Practice Address - Phone:630-524-0303
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-03-22
Last Update Date:2021-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide