BHAVANA P VAIDYA


Address: 6307 S Stewart Ave Ste 201, Chicago, IL 60621-3116
Phone: 7739624025

BHAVANA P VAIDYA (NPI# 1437141108) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1437141108
Entity Type Individual
Full Name BHAVANA P VAIDYA
Credential MD
Practice Address 6307 S Stewart Ave Ste 201
Chicago
IL 60621-3116
Mailing Address 10601 S Kilbourn Ave
Oak Lawn
IL 60453-5341
Practice Telephone 7739624025
Mailing Telephone 7084252516
Enumeration Date 2005-08-18
Last Update Date 2018-03-22
Gender Code F
Is Sole Proprietor Y

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
N 208100000X Physical Medicine & Rehabilitation 036066303 IL Allopathic & Osteopathic Physicians
Y 208D00000X General Practice 036066303 IL Allopathic & Osteopathic Physicians

Other Provider Identifier

State Issuer Identifier Type Code
IL CAQH 11871240 01
DEA AV2063117 01
IL BC 316009776 01
IL PTAN 711960 01
IL 036066303 05

Office Location

Street Address 6307 S STEWART AVE STE 201
City CHICAGO
State IL
Zip Code 60621-3116

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1194127787 Aaa-1 Transportation Secured Medical Transport (VAN) 5740 S Emerald Ave, Chicago, IL 60621 2014-09-25
1871893859 Anuj Jain Family Medicine 6508 S Halsted Street, Chicago, IL 60621 2010-10-25
1750538104 Adolfo M. Maglaya, M.d., S.c. Internal Medicine 326 W. 64th St., Chicago, IL 60621 2008-08-27
1083882997 Englewood Satellite Senior Center Clinic/Center 657 W. 63rd St, Chicago, IL 60621 2008-02-13
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Taxonomy Information

Taxonomy Code 208D00000X
Grouping Allopathic & Osteopathic Physicians
Classification General Practice

Taxonomy Definition

Definition to come...

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1164067054 League Corp. General Practice 515 N State St Fl 8, Chicago, IL 60654-9102 2019-11-14
1679129977 Chronic Care Solutions LLC General Practice 3050 W Columbia Ave, Chicago, IL 60645-4006 2019-08-13
1952809451 Josie M Abogast General Practice 3219 N. Clark St., Chicago, IL 60657 2018-01-30
1043759939 Royalty Intervention Group Inc General Practice 10307 S Peoria St, Suite 100, Chicago, IL 60643-3007 2017-02-13
1215482567 David John De Jong General Practice 226 W Willow St, Chicago, IL 60614-5716 2016-08-16
1720474885 Healthwise Medical Clinic LLC General Practice 8349 S Baltimore Ave, Chicago, IL 60617-2110 2015-04-15
1578952321 Joseph Lawrence Mcdevitt General Practice 2650 N Orchard St Apt 2f, Chicago, IL 60614-1576 2015-01-16
1548662851 Healthjoy General Practice 208 W Huron St, Chicago, IL 60654-3913 2014-09-17
1629478359 Alivio Medical Center General Practice 1450-1510 W. Cermak Road, Chicago, IL 60608 2014-08-29
1699193409 Kenya R Thomas General Practice 1133 E 83rd St Unit 108, Chicago, IL 60619-6464 2014-03-31
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Competitor

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City CHICAGO
Zip Code 60621

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Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES)
Jurisdiction Medicare & Medicaid

This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.

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