Amarjit S Bhasin MD LTD
Organization Active NPI Neurology Physician · Hazel Crest, IL
NPI 1891984019 · NPPES record last updated Oct 24, 2007
Key facts
- NPI
- 1891984019
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Neurology Physician 2084N0400X
- Legal business name
- AMARJIT S BHASIN MD LTD
- Practice address
- 17680 Kedzie Ave
Suite 105
Hazel Crest, IL 60429 - Phone
- (708) 799-3044
- Fax
- (708) 799-2441
- NPI assigned
- Oct 24, 2007
- Organization subpart
- No
Authorized official
- Name
- Dr. Amarjit Singh Bhasin, MD
- Title
- Neurologist President
- Phone
- (708) 799-3044
Practitioners 2
-
Henry M Andoh, M.D
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled (2 enrollments) in IL, IN
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20080903000079 | IL | Part B Supplier - Clinic/Group Practice | 8628144466 |
Receives reassigned benefits from 1 practitioner Practice locations: Hazel Crest, IL |
| O20080917000584 | IN | Part B Supplier - Clinic/Group Practice | 8628144466 |
Receives reassigned benefits from 1 practitioner Practice locations: Dyer, IN; Munster, IN |
National Provider Directory
Locations
17680 Kedzie Ave
Ste 105
Hazel Crest, IL 60429
Phone (708) 672-9738
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Neurology Physician |
2084N0400X | IL | Yes |
Addresses
Primary practice location
17680 Kedzie Ave
Suite 105
Hazel Crest, IL 60429
Mailing address
17680 Kedzie Ave
Suite 105
Hazel Crest, IL 60429
Phone (708) 799-3044
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 100273770 | Medicaid | IN | |
| 036063300 | Medicaid | IL |
Other providers in Hazel Crest, IL
- Allbright Medical Supply & Transportation, Inc.
- Natalie Allen
- Abdulah Alrifai
- Shadwan F Alsafwah
- Ayman Alzubi
- Mark Ambrose
- American Therapy Providers LLC.
- Veronica Jane Ammar
- Amanda Anderson
- Rebecca Lynn Anderson
All providers in Hazel Crest, IL · Neurology Physician in Illinois
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 24, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.