| Doctor Name: | DR. BASHI BANDARI |
| NPI Number: | 1043291818 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | MD |
| License Number: | 036061994 |
| Business Practice Address: | 1111 Superior St Melrose Park, IL - 601604138 |
| Business Phone Number: | 7083444547 |
| Business Fax Number: | |
| Mailing Address: | 1111 Superior St, MELROSE PARK |
| State: | IL |
| Postal Code: | 601604138 |
| Phone Number: | 7083444547 |
| Fax Number: | |
| NPI Enumeration Date: | 11/09/2005 |
| NPI Last Update Date: | 09/11/2013 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 207QA0505X |
| License Number: | 036061994 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | IL |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | Family Medicine |
| Taxonomy Specialization: | Adult Medicine |
| Taxonomy Definition: | |