Vaidya, Bhavana P

Vaidya, Bhavana P is an sole proprietor health care provider with primary practice located at 6307 S Stewart Ave Ste 201 , Chicago IL 60621-3116. She recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Physical Medicine & Rehabilitation, Allopathic & Osteopathic Physicians / General Practice. Allopathic & Osteopathic Physicians / General Practice is her primary health care specialty. Vaidya, Bhavana P can be contacted via phone (773) 962-4025.

Contact Information

Primary practice address
6307 S Stewart Ave Ste 201 Chicago IL 60621-3116
Phone: (773) 962-4025
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Physical Medicine & Rehabilitation 208100000X 036066303 Illinois
Allopathic & Osteopathic Physicians / General Practice 208D00000X 036066303 Illinois

Profile Details

NPI number 1437141108
LBN Legal business name Vaidya, Bhavana P
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Aug 18th, 2005
Last updated Mar 7th, 2023 - about 3 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1437141108 NPPES
Illinois Other 11871240 CAQH
Illinois Other 711960 CAQH
Illinois Other 316009776 CAQH
Illinois MEDICAID 036066303 CAQH

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