Rohail Isaac Bhurgri, DMD
Individual provider Active NPI Dentist · Minooka, IL
NPI 1891472064 · NPPES record last updated Jun 29, 2023
Key facts
- NPI
- 1891472064
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Dentist 122300000X
- License
- 019.034458 (IL)
- Practice address
- 515 US Highway 6
Minooka, IL 60447-8814 - Phone
- (815) 620-0889
- NPI assigned
- Jun 29, 2023
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 019.034458 | IL | MD | Dentist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Dental Professionals of Illinois, P.C. | Current |
Accepting new patients |
Locations
515 US Highway 6
Minooka, IL 60447
Phone (815) 620-0889
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 019.034458 | IL | Yes |
Addresses
Primary practice location
515 US Highway 6
Minooka, IL 60447-8814
Mailing address
2729 Emerald Dr
Ottawa, IL 61350-1083
Phone (815) 830-7580
Other providers in Minooka, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 29, 2023. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.