Varsha Bhan MD SC

Primary specialty

Primary Care Clinic/CenterTaxonomy code 261QP2300X

License

036098405 Issued in IL

Legal business name

VARSHA BHAN MD SC

Practice address

17850 Kedzie Ave
Suite 1700
Hazel Crest, IL 60429-2058

Phone

(708) 669-1630

Fax

(708) 799-2261

NPI assigned

Jun 11, 2008

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Varsha Bhan, MDNPI 1326024357

Title

Physician

Phone

(708) 669-1630

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in IL

Enrollment records 1

Locations

Interoperability endpoints

• FHIR API: https://fhir4.healow.com/fhir/r4/GGGECA

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Varsha Bhan, MD

  • Internal Medicine Physician
  • Hazel Crest, IL
  • NPI 1326024357
  Medicare reassignment NPD Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1213142400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1213142400000",
    "number": "1013177278",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17850 SOUTH KEDZIE AVE",
            "address_2": "SUITE 1700",
            "city": "HAZEL CREST",
            "state": "IL",
            "postal_code": "60429",
            "telephone_number": "708-669-1630",
            "fax_number": "708-799-2261"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17850 KEDZIE AVE",
            "address_2": "SUITE 1700",
            "city": "HAZEL CREST",
            "state": "IL",
            "postal_code": "604292058",
            "telephone_number": "708-669-1630",
            "fax_number": "708-799-2261"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VARSHA BHAN MD SC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-06-11",
        "last_updated": "2008-06-11",
        "status": "A",
        "authorized_official_last_name": "BHAN",
        "authorized_official_first_name": "VARSHA",
        "authorized_official_title_or_position": "PHYSICIAN",
        "authorized_official_telephone_number": "708-669-1630",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": "IL",
            "license": "036098405",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036098405",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Primary Care Clinic/Center in Hazel Crest, IL
• Providers in Hazel Crest, IL by specialty
• Primary Care Clinic/Center in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 11, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.