Healthcare Provider Details

I. General information

NPI: 1780373050
Provider Name (Legal Business Name): ESHA VAISH M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/03/2023
Last Update Date: 09/16/2026
Certification Date: 09/16/2026
Deactivation Date: 12/07/2023
Reactivation Date: 04/24/2026

III. Provider practice location address

1969 W OGDEN AVE
CHICAGO IL
60612-3765
US

IV. Provider business mailing address

1000 10TH AVENUE 3RD FLOOR ROOM 3A-08
NEW YORK NY
10019
US

V. Phone/Fax

Practice location:
  • Phone: 312-864-3034
  • Fax:
Mailing address:
  • Phone: 212-259-6731
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License Number036.180438
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: