Individual
DR. SURESH BHALLA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
210 N HAMMES AVE, SUITE 112, JOLIET, IL 60435-6680
(815) 744-2054
(815) 744-5823
Mailing address
210 N HAMMES AVE, SUITE 112, JOLIET, IL 60435-6680
(815) 744-2054
(815) 744-5823
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
036062964
IL
207RG0100X
Gastroenterology Physician
Primary
036062964
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036062964
—
IL
Enumeration date
07/08/2005
Last updated
11/21/2016
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