Provider Demographics
NPI:1407929797
Name:BHOBE, SWATI SUYOG (MD)
Entity type:Individual
Prefix:DR
First Name:SWATI
Middle Name:SUYOG
Last Name:BHOBE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1585 N RAND RD
Mailing Address - Street 2:
Mailing Address - City:PALATINE
Mailing Address - State:IL
Mailing Address - Zip Code:60074-2919
Mailing Address - Country:US
Mailing Address - Phone:847-934-9153
Mailing Address - Fax:
Practice Address - Street 1:1585 N RAND RD
Practice Address - Street 2:
Practice Address - City:PALATINE
Practice Address - State:IL
Practice Address - Zip Code:60074-2919
Practice Address - Country:US
Practice Address - Phone:847-934-7969
Practice Address - Fax:847-934-9243
Is Sole Proprietor?:No
Enumeration Date:2006-11-16
Last Update Date:2021-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036099191208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
ILH 16722Medicare UPIN