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General NPI Number Information
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NPI Number | 1003500703
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Entity Type | Organization
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Legal Business Name | VEIN & VASCULAR EXPERTS, PLLC
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Dates
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Enumeration Date | 06/06/2023
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Last Update Date | 02/06/2025
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Provider Practice Location Address
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Address Line | 20060 GOVERNORS DR STE 100
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City | OLYMPIA FIELDS
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State | IL
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Zip | 60461-1029
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Country | US
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Telephone | 708-821-7794
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Fax |
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Provider Business Mailing Address
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Address Line | 20060 GOVERNORS DR STE 100
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City | OLYMPIA FIELDS
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State | IL
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Zip | 60461-1029
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Country | US
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Telephone | 708-323-4000
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Fax | 877-673-3450
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Authorized Official
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Title or Position | OWNER
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Name | SANJEEV KUMAR PRADHAN
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Credential | MD
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Telephone | 708-323-4000
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2086S0129X
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Taxonomy Name | Vascular Surgery Physician
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License Number |
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License Number State |
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