Bahadur, Shruti
Bahadur, Shruti is an individual health care provider with primary practice located at 650 Dakota St Ste A , Crystal Lake IL 60012. She recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as her primary health care specialty. Bahadur, Shruti can be contacted via phone (815) 455-6000.Contact Information
Primary practice address
650 Dakota St Ste A
Crystal Lake IL 60012
Phone: (815) 455-6000
Fax: (815) 356-1104
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Family Medicine | 207Q00000X | 036120476 | Illinois |
Profile Details
| NPI number | 1508035304 |
|---|---|
| LBN Legal business name | Bahadur, Shruti |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Feb 26th, 2008 |
| Last updated | Jan 31st, 2019 - about 5 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1508035304 | NPPES |
| Illinois | Other | 036120476 | STATE LICENSE |
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