Healthcare Provider Details

I. General information

NPI: 1144803909
Provider Name (Legal Business Name): RIYA VYAS DPM
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/29/2021
Last Update Date: 04/23/2026
Certification Date: 04/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1220 HOBSON RD
NAPERVILLE IL
60540-8139
US

IV. Provider business mailing address

1339 N DEARBORN ST APT 14A
CHICAGO IL
60610-6024
US

V. Phone/Fax

Practice location:
  • Phone: 630-548-3900
  • Fax:
Mailing address:
  • Phone: 614-353-7934
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code213ES0103X
TaxonomyFoot & Ankle Surgery Podiatrist
License Number016006096
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: