Individual
JANE K. BAHK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
1 ERIE CT, SUITE 6140, OAK PARK, IL 60302-2566
(708) 848-2400
(708) 445-8269
Mailing address
260 E CHESTNUT ST, UNIT 612, CHICAGO, IL 60611-2401
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
036102713
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0031600193
BLUE SHIELD
IL
05
—
036102713
—
IL
01
—
180041057
RAILROAD MEDICARE
IL
01
—
K46497
MEDICARE PROVIDER NUMBER
IL
Enumeration date
01/11/2006
Last updated
07/03/2008
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