Individual
PRIYA BHAKTA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
2160 S 1ST AVE, MAYWOOD, IL 60153-3328
(708) 216-9000
Mailing address
2900 N LAKE SHORE DR, CHICAGO, IL 60657-5640
(773) 665-6237
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
036.153552
IL
208600000X
Surgery Physician
35145071
OH
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
03/28/2017
Last updated
10/12/2023
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