Basic Information
| Provider Information | |||||||||
| NPI: | 1952074049 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | SHRESTHA | ||||||||
| FirstName: | DHAN | ||||||||
| MiddleName: | BAHADUR | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | JR. | ||||||||
| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1009 S OAKLEY BLVD APT 2R | ||||||||
| Address2: | |||||||||
| City: | CHICAGO | ||||||||
| State: | IL | ||||||||
| PostalCode: | 606122268 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2243683378 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 1500 S FAIRFIELD AVE # F-914 | ||||||||
| Address2: | |||||||||
| City: | CHICAGO | ||||||||
| State: | IL | ||||||||
| PostalCode: | 606081782 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7732575914 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 07/26/2021 | ||||||||
| LastUpdateDate: | 07/26/2021 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 07/26/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207R00000X | 079132 | IL | Y | Allopathic & Osteopathic Physicians | Internal Medicine |
No ID Information.