Provider Demographics
NPI:1174773113
Name:BHATIA, SHAILENDER K (MD)
Entity type:Individual
Prefix:
First Name:SHAILENDER
Middle Name:K
Last Name:BHATIA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:2800 W 95TH ST
Mailing Address - Street 2:DEPT OF RADIOLOGY
Mailing Address - City:EVERGREEN PARK
Mailing Address - State:IL
Mailing Address - Zip Code:60805-2701
Mailing Address - Country:US
Mailing Address - Phone:708-229-5651
Mailing Address - Fax:708-229-5387
Practice Address - Street 1:2800 W 95TH ST
Practice Address - Street 2:DEPT OF RADIOLOGY
Practice Address - City:EVERGREEN PARK
Practice Address - State:IL
Practice Address - Zip Code:60805-2701
Practice Address - Country:US
Practice Address - Phone:708-229-5651
Practice Address - Fax:708-229-5387
Is Sole Proprietor?:No
Enumeration Date:2008-09-26
Last Update Date:2013-09-04
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
IL036.1236982085R0204X, 2085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0204XAllopathic & Osteopathic PhysiciansRadiologyVascular & Interventional Radiology
No2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology