Provider Demographics
NPI:1932195039
Name:BHATTI, RABIA Z (MD)
Entity Type:Individual
Prefix:
First Name:RABIA
Middle Name:Z
Last Name:BHATTI
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1950 N HARLEM AVE
Mailing Address - Street 2:
Mailing Address - City:ELMWOOD PARK
Mailing Address - State:IL
Mailing Address - Zip Code:60707
Mailing Address - Country:US
Mailing Address - Phone:708-453-6800
Mailing Address - Fax:708-453-3985
Practice Address - Street 1:1950 N HARLEM AVE
Practice Address - Street 2:
Practice Address - City:ELMWOOD PARK
Practice Address - State:IL
Practice Address - Zip Code:60707-3717
Practice Address - Country:US
Practice Address - Phone:708-453-6800
Practice Address - Fax:708-453-3235
Is Sole Proprietor?:Yes
Enumeration Date:2005-09-23
Last Update Date:2022-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036-089015208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL203009OtherMEDICARE
IL36089015Medicaid
IL36089015Medicaid