Healthcare Provider Details

I. General information

NPI: 1740628726
Provider Name (Legal Business Name): VIKASH KUMAR SINHA MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/12/2013
Last Update Date: 10/29/2024
Certification Date: 10/29/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

757 E 81ST AVE
MERRILLVILLE IN
46410-5538
US

IV. Provider business mailing address

PO BOX 3877
JOLIET IL
60434-3877
US

V. Phone/Fax

Practice location:
  • Phone: 219-472-0379
  • Fax:
Mailing address:
  • Phone: 815-741-6830
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RN0300X
TaxonomyNephrology Physician
License Number036132987
License Number StateIL
# 2
Primary TaxonomyY
Taxonomy Code207RN0300X
TaxonomyNephrology Physician
License Number01074975A
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: