Individual provider Active NPI

Bhavna Balaney, MD

  • Cardiovascular Disease Physician
  • Chicago, IL
National Provider Identifier
1083913255
Registry record updated Aug 14, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
License
036137323 Issued in IL
Practice address
2734 W 87TH St
Chicago, IL 60652-3937
Phone
(773) 918-4700
Fax
(872) 213-5685
NPI assigned
Mar 27, 2011
Last updated
Aug 14, 2019By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 14, 2019

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X NU
Internal Medicine Physician 207R00000X 036137323 IL
Cardiovascular Disease Physician 207RC0000X 036137323 IL Primary

Addresses

Primary practice location

2734 W 87TH St
Chicago, IL 60652-3937

Mailing address

2734 W 87TH St
Chicago, IL 60652-3937
Phone (773) 918-4700

Other practice location 1

19310 S Halsted St
Glenwood, IL 60425-1562
Phone (708) 300-3132

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20180719003096 IL Practitioner - Cardiovascular Disease (Cardiology)Practitioner - Internal Medicine 6002112885 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
PMR Illinois Holding, LLC CurrentSince Jan 1, 2022 Accepting new patients

Locations

1395 NW 167th St
Miami Gardens, FL 33169
Phone (305) 831-4760

6326 Cermak Rd
Berwyn, IL 60402
Phone (708) 303-9234

2231 E 95th St
Chicago, IL 60617
Phone (773) 768-7700

2734 W 87th St
Chicago, IL 60652
Phone (773) 918-4700

19310 S Halsted St
Glenwood, IL 60425
Phone (708) 300-3132

6101 W 95th St
Oak Lawn, IL 60453
Phone (708) 261-0831

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1301184000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1565740800000",
    "number": "1083913255",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2734 W 87TH ST",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606523937",
            "telephone_number": "773-918-4700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2734 W 87TH ST",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606523937",
            "telephone_number": "773-918-4700",
            "fax_number": "872-213-5685"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "19310 S Halsted St",
            "address_purpose": "LOCATION",
            "city": "Glenwood",
            "state": "IL",
            "postal_code": "604251562",
            "country_code": "US",
            "telephone_number": "708-300-3132",
            "fax_number": "872-213-5687",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BALANEY",
        "first_name": "BHAVNA",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-03-27",
        "last_updated": "2019-08-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "IL",
            "license": "036137323",
            "primary": false
        },
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "IL",
            "license": "036137323",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.