Individual
DR. MANEESHA BHATT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
101 W UNIVERSITY AVE, CHAMPAIGN, IL 61820-3981
(217) 366-1285
Mailing address
101 W UNIVERSITY AVE, CHAMPAIGN, IL 61820-3981
(217) 366-1285
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
036119010
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
110800000407895100
—
MD
Enumeration date
03/20/2006
Last updated
05/08/2024
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