Healthcare Provider Details

I. General information

NPI: 1316546641
Provider Name (Legal Business Name): VANESSA K BAJAJ APRN, FNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: VANESSA JIMENEZ

II. Dates (important events)

Enumeration Date: 10/19/2020
Last Update Date: 04/30/2026
Certification Date: 04/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1090 S BARRINGTON RD
STREAMWOOD IL
60107-2298
US

IV. Provider business mailing address

PO BOX 746715
ATLANTA GA
30374-6715
US

V. Phone/Fax

Practice location:
  • Phone: 630-477-7201
  • Fax: 630-429-9874
Mailing address:
  • Phone: 630-477-7201
  • Fax: 630-429-9874

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number277.005569
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: