Provider Demographics
NPI:1902957822
Name:EXCELLENT HEALTH CARE SERVICES, INC.
Entity Type:Organization
Organization Name:EXCELLENT HEALTH CARE SERVICES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:JAYANT
Authorized Official - Middle Name:C
Authorized Official - Last Name:BHALERAO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:708-364-1205
Mailing Address - Street 1:11912 STERLING DR
Mailing Address - Street 2:
Mailing Address - City:ORLAND PARK
Mailing Address - State:IL
Mailing Address - Zip Code:60467-1412
Mailing Address - Country:US
Mailing Address - Phone:708-364-1205
Mailing Address - Fax:708-364-1265
Practice Address - Street 1:62 ORLAND SQUARE DR
Practice Address - Street 2:SUITE 202
Practice Address - City:ORLAND PARK
Practice Address - State:IL
Practice Address - Zip Code:60462-6546
Practice Address - Country:US
Practice Address - Phone:708-364-1205
Practice Address - Fax:708-364-1265
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-16
Last Update Date:2010-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL36046837207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular DiseaseGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
H96430Medicare UPIN
D13185Medicare UPIN
D10237Medicare UPIN
C42602Medicare UPIN
E19306Medicare UPIN
ILC51058Medicare UPIN
IL211794Medicare PIN