Provider Demographics
NPI:1841446788
Name:BHATIA, ARVIN KUMAR (MD)
Entity type:Individual
Prefix:DR
First Name:ARVIN
Middle Name:KUMAR
Last Name:BHATIA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:302 RANDALL RD
Mailing Address - Street 2:
Mailing Address - City:GENEVA
Mailing Address - State:IL
Mailing Address - Zip Code:60134-4209
Mailing Address - Country:US
Mailing Address - Phone:630-262-7400
Mailing Address - Fax:630-262-3760
Practice Address - Street 1:302 RANDALL RD
Practice Address - Street 2:
Practice Address - City:GENEVA
Practice Address - State:IL
Practice Address - Zip Code:60134-4209
Practice Address - Country:US
Practice Address - Phone:630-262-7400
Practice Address - Fax:630-262-3760
Is Sole Proprietor?:No
Enumeration Date:2008-08-12
Last Update Date:2014-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL125-050973207R00000X
IL036123230207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL206147OtherMEDICARE PTAN (GROUP)
IL036123230Medicaid
ILF400099426OtherMEDICARE PTAN (INDIVIDUAL)
ILCA4748OtherMEDICARE RR (GROUP)
ILP01308437OtherMEDICARE RR (INDIVIDUAL)