Bhallamd, LLC

Primary specialty

Geriatric Medicine (Internal Medicine) PhysicianTaxonomy code 207RG0300X

Legal business name

BHALLAMD, LLC

Practice address

4415 Harrison Street, #300
Hillside, IL 60162-1953

Phone

(708) 632-5600

Fax

(708) 632-5602

NPI assigned

Sep 6, 2016

Last updated

Jul 11, 2023By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mr. Jake Mathew

Title

Business Office Manager

Phone

(708) 632-5600

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in IL

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Samir Bhalla, MD

  • Geriatric Medicine (Internal Medicine) Physician
  • Hillside, IL
  • NPI 1922365170
  Medicare reassignment

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

{
    "created_epoch": "1473120000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1689033600000",
    "number": "1710434964",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4415 HARRISON STREET, #300",
            "city": "HILLSIDE",
            "state": "IL",
            "postal_code": "601621953",
            "telephone_number": "708-632-5600",
            "fax_number": "708-632-5602"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4415 HARRISON STREET, #300",
            "city": "HILLSIDE",
            "state": "IL",
            "postal_code": "601621953",
            "telephone_number": "708-632-5600",
            "fax_number": "708-632-5602"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BHALLAMD, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-09-06",
        "last_updated": "2023-07-11",
        "certification_date": "2023-07-11",
        "status": "A",
        "authorized_official_last_name": "MATHEW",
        "authorized_official_first_name": "JAKE",
        "authorized_official_title_or_position": "BUSINESS OFFICE MANAGER",
        "authorized_official_telephone_number": "708-632-5600",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207RG0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Geriatric Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Monica Bembry
• Ashley Rose Benain
• Valerie Bennett
• Best Covid Care LLC
• Samir Bhalla, MD
• Kristina Bogoevski
• Kimberly Grace Bokowski, PT
• Ann-Preston Bosher, DPT
• Kyle Boyd, ATC
• Quiana Braden, NCC

• Geriatric Medicine (Internal Medicine) Physician in Hillside, IL
• Providers in Hillside, IL by specialty
• Geriatric Medicine (Internal Medicine) Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 11, 2023; 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.