Individual
DR. MUKUL BHATTARAI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD.
Contact information
Practice address
747 N RUTLEDGE ST FL 4, SPRINGFIELD, IL 62702-6700
(217) 545-8000
(217) 545-7877
Mailing address
201 E MADISON ST STE 328, SPRINGFIELD, IL 62702-5131
(217) 545-8000
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
036-135174
IL
207R00000X
Internal Medicine Physician
MT198824
PA
207RC0000X
Cardiovascular Disease Physician
Primary
036-135174
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036135174
—
IL
Enumeration date
07/07/2011
Last updated
05/03/2022
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