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Individual

AJAY BAJAJ

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
4901 W 79TH ST, SUITE 1, BURBANK, IL 60459-1554
(708) 636-0006
(708) 636-0007
Mailing address
4901 W 79TH ST, SUITE 1, BURBANK, IL 60459-1554
(708) 636-0006
(708) 636-0007

Taxonomy

Speciality
Code
Description
License number
State
207RG0100X
Gastroenterology Physician
Primary
036078076
IL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
01621679
BCBS OF IL
IL
05
036078076
IL
01
21608842
BCBS IL
01
995270
MEDICARE GROUP
IL
01
995271
MEDICARE GROUP
IL
Enumeration date
12/21/2005
Last updated
06/23/2008
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