NPIMap

Organization Active NPI

Renuka H Bhatt MDSC

  • Dermatology Physician
  • Joliet, IL
National Provider Identifier
1689743783
Registry record updated Sep 29, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
License
036086915 Issued in IL
Legal business name
RENUKA H BHATT MDSC
Practice address
2202 Essington Rd
Suite 101
Joliet, IL 60435-1634
Phone
(815) 676-5307
Fax
(815) 725-1321
NPI assigned
Nov 6, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 29, 2010

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

Authorized official

Name
Renuka H Bhatt, MDNPI 1316128861
Title
Doctor
Phone
(815) 676-5310

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207N00000X 036086915 IL Primary

Addresses

Primary practice location

2202 Essington Rd
Suite 101
Joliet, IL 60435-1634

Mailing address

2202 Essington Rd
Suite 101
Joliet, IL 60435-1634
Phone (815) 676-5307

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20060316000486 IL Part B Supplier - Clinic/Group Practice 1557378478 Receives reassigned benefits from 11 practitioners
Practice locations: Burr Ridge, IL; Joliet, IL; New Lenox, IL; Orland Park, IL

National Provider Directory

National Provider Directory

Locations

570 Village Center Dr
Ste 201
Burr Ridge, IL 60527
Phone (312) 549-8961

570 Village Center Dr
Ste 210
Burr Ridge, IL 60527

2000 Glenwood Ave
Ste 109
Joliet, IL 60435
Phone (815) 725-0900

2202 Essington Rd
Ste 100
Joliet, IL 60435

120 Batson Ct
Ste 201
New Lenox, IL 60451
Phone (630) 640-6090

120 Batson Ct
New Lenox, IL 60451
Phone (815) 717-8515

Practitioners & affiliated clinicians

Practitioners 14

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

View all 14

NPI Registry JSON

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

{
    "created_epoch": "1162771200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1285718400000",
    "number": "1689743783",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2202 ESSINGTON RD",
            "address_2": "SUITE 101",
            "city": "JOLIET",
            "state": "IL",
            "postal_code": "604351634",
            "telephone_number": "815-676-5307",
            "fax_number": "815-725-1321"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2202 ESSINGTON RD",
            "address_2": "SUITE 101",
            "city": "JOLIET",
            "state": "IL",
            "postal_code": "604351634",
            "telephone_number": "815-676-5307",
            "fax_number": "815-725-1321"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RENUKA H BHATT MDSC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-06",
        "last_updated": "2010-09-29",
        "status": "A",
        "authorized_official_last_name": "BHATT",
        "authorized_official_first_name": "RENUKA",
        "authorized_official_middle_name": "H",
        "authorized_official_title_or_position": "DOCTOR",
        "authorized_official_telephone_number": "815-676-5310",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dermatology",
            "state": "IL",
            "license": "036086915",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Joliet, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 29, 2010; 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.