Individual
DR. BHARAT S JAILWALA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
846 DUNDEE AVE, ELGIN, IL 60120-3068
(847) 695-3555
(847) 695-5937
Mailing address
846 DUNDEE AVENUE, ELGIN, IL 60120-3068
(847) 695-3555
(847) 695-5937
Taxonomy
Speciality
Code
Description
License number
State
2085R0001X
Radiation Oncology Physician
Primary
036066206
IL
261QX0203X
Radiation Oncology Clinic/Center
036066206
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
4520831
BLUE CROSS BLUE SHIELD
IL
01
—
P00097762
RAILROAD MEDICARE PIN
IL
Enumeration date
08/18/2006
Last updated
05/15/2024
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