Individual
MANALI AJAY BHAVE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
251 E HURON ST, NORTHWESTERN MEMORIAL HOSPITAL, CHICAGO, IL 60611
(224) 420-1103
Mailing address
220 E ILLINOIS ST APT 1106, CHICAGO, IL 60611-4365
(224) 420-1103
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
125059165
IL
207RX0202X
Medical Oncology Physician
-
GA
207RX0202X
Medical Oncology Physician
Primary
080666
GA
Other
Enumeration date
06/05/2011
Last updated
06/04/2018
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