Bhanushali, Gautam K

Bhanushali, Gautam K is an sole proprietor health care provider with primary practice located at 2701 W 68Th Street Professional Pavilion 4 South, Chicago IL 60629. He recently has only one registered license in Allopathic & Osteopathic Physicians / Nephrology, which is considered as his primary health care specialty. Bhanushali, Gautam K can be contacted via phone (773) 735-4884.

Contact Information

Primary practice address
2701 W 68Th Street Professional Pavilion 4 South Chicago IL 60629
Phone: (773) 735-4884
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Nephrology 207RN0300X 036132193 Illinois

Profile Details

NPI number 1073829990
LBN Legal business name Bhanushali, Gautam K
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Aug 30th, 2010
Last updated Feb 2nd, 2023 - about 2 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1073829990 NPPES
Illinois Other 922820024 MEDICARE

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