Provider Demographics
NPI:1952439200
Name:MEGHPARA, BHAGVANJI (DO)
Entity Type:Individual
Prefix:
First Name:BHAGVANJI
Middle Name:
Last Name:MEGHPARA
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3330 W 177TH ST
Mailing Address - Street 2:UNIT 1 B
Mailing Address - City:HAZEL CREST
Mailing Address - State:IL
Mailing Address - Zip Code:60429-2185
Mailing Address - Country:US
Mailing Address - Phone:708-799-9490
Mailing Address - Fax:708-799-9773
Practice Address - Street 1:3330 W 177TH ST
Practice Address - Street 2:UNIT 1 B
Practice Address - City:HAZEL CREST
Practice Address - State:IL
Practice Address - Zip Code:60429-2185
Practice Address - Country:US
Practice Address - Phone:708-799-9490
Practice Address - Fax:708-799-9773
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-01
Last Update Date:2021-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036094935207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL036094935Medicaid
H06035Medicare UPIN
K23978Medicare ID - Type Unspecified