Basic Information
| Provider Information | |||||||||
| NPI: | 1801200944 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | BHATIA | ||||||||
| FirstName: | ANKIT | ||||||||
| MiddleName: | KRISHAN | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 5841 S MARYLAND AVE STE MC7082 | ||||||||
| Address2: | INTERNAL MEDICINE | ||||||||
| City: | CHICAGO | ||||||||
| State: | IL | ||||||||
| PostalCode: | 606371465 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7737026840 | ||||||||
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| Practice Location | |||||||||
| Address1: | 2123 AUBURN AVE STE 137 | ||||||||
| Address2: | |||||||||
| City: | CINCINNATI | ||||||||
| State: | OH | ||||||||
| PostalCode: | 452192906 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5132061180 | ||||||||
| FaxNumber: | 5132061183 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/17/2014 | ||||||||
| LastUpdateDate: | 04/06/2022 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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| NPICertificationDate: | 04/06/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207R00000X | 125-065318 | IL | N | Allopathic & Osteopathic Physicians | Internal Medicine | 207RA0001X | 35143071 | OH | Y |
ID Information
| ID | Type | State | Issuer | Description | 0455319 | 05 | OH | MEDICAID |