Provider Demographics
NPI:1992504831
Name:BHAKTA, RAHUL (DC)
Entity type:Individual
Prefix:DR
First Name:RAHUL
Middle Name:
Last Name:BHAKTA
Suffix:
Gender:
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1841 W 21ST ST UNIT 3W
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60608-2714
Mailing Address - Country:US
Mailing Address - Phone:507-491-8360
Mailing Address - Fax:
Practice Address - Street 1:1101 S CANAL ST STE 102
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60607-4935
Practice Address - Country:US
Practice Address - Phone:312-424-8500
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-03-12
Last Update Date:2025-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL038.014122111NS0005X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NS0005XChiropractic ProvidersChiropractorSports Physician