Individual
ASHISH C BHATIA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
550 E DEVON AVE STE 200, ITASCA, IL 60143-2639
(864) 625-3376
(855) 792-2250
Mailing address
550 E DEVON AVE STE 200, ITASCA, IL 60143-2639
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
036111397
IL
207ND0101X
MOHS-Micrographic Surgery Physician
036111397
IL
207NS0135X
Procedural Dermatology Physician
Primary
036111397
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
P00174102
RR MEDICARE
IL
Enumeration date
11/18/2005
Last updated
02/25/2025
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