Healthcare Provider Details

I. General information

NPI: 1134299779
Provider Name (Legal Business Name): BARISURA PRIVATE LTD
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/09/2006
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9011 S COMMERCIAL AVE
CHICAGO IL
60617
US

IV. Provider business mailing address

9410 COMPUBILL DR
ORLAND PARK IL
60462
US

V. Phone/Fax

Practice location:
  • Phone: 773-933-0700
  • Fax: 773-933-7407
Mailing address:
  • Phone: 708-460-7444
  • Fax: 708-460-8662

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207U00000X
TaxonomyNuclear Medicine Physician
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code207UN0901X
TaxonomyNuclear Cardiology Physician
License Number
License Number State

VIII. Authorized Official

Name: VIRENDRA S BISLA
Title or Position: PRESIDENT
Credential: MD
Phone: 773-933-0700