Provider Demographics
NPI:1457623357
Name:BEHL, ANKUR RISHI (MD)
Entity Type:Individual
Prefix:DR
First Name:ANKUR
Middle Name:RISHI
Last Name:BEHL
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1310 N MAIN ST STE 100
Mailing Address - Street 2:
Mailing Address - City:SANDWICH
Mailing Address - State:IL
Mailing Address - Zip Code:60548-1394
Mailing Address - Country:US
Mailing Address - Phone:815-758-0000
Mailing Address - Fax:815-786-3603
Practice Address - Street 1:1310 N MAIN ST STE 100
Practice Address - Street 2:
Practice Address - City:SANDWICH
Practice Address - State:IL
Practice Address - Zip Code:60548-1394
Practice Address - Country:US
Practice Address - Phone:815-758-0000
Practice Address - Fax:815-786-3603
Is Sole Proprietor?:No
Enumeration Date:2012-02-08
Last Update Date:2020-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036-132684207XX0005X, 207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
No207XX0005XAllopathic & Osteopathic PhysiciansOrthopaedic SurgerySports Medicine