Healthcare Provider Details

I. General information

NPI: 1083679963
Provider Name (Legal Business Name): RAJESHWARI CHAVDA MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/20/2006
Last Update Date: 03/06/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

800 W CENTRAL ROAD
ARLINGTON HEIGHTS IL
60005
US

IV. Provider business mailing address

DEPT 4392
CAROL STREAM IL
60122-4392
US

V. Phone/Fax

Practice location:
  • Phone: 866-344-0543
  • Fax: 866-344-3934
Mailing address:
  • Phone: 866-540-5303
  • Fax: 724-502-4070

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RP1001X
TaxonomyPulmonary Disease Physician
License Number36111699
License Number StateIL
# 2
Primary TaxonomyY
Taxonomy Code207RC0200X
TaxonomyCritical Care Medicine (Internal Medicine) Physician
License Number36111699
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: