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1497890750 NPI number — BALASUBRAMANIAM S IYER MD

NPI Number: 1497890750
Health Care Provider/Practitioner: BALASUBRAMANIAM S IYER MD

Information about “1497890750” NPI (BALASUBRAMANIAM S IYER MD) exists in 1497890750 in HTML format HTML  |  1497890750 in plain Text format TXT  |  1497890750 in PDF (Portable Document Format) PDF  |  1497890750 in an XML format XML  formats.

NPI Number : 1497890750 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1497890750",
    "EntityType": "Individual",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": "Y",
    "IsOrgSubpart": null,
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": null,
    "LastName": "IYER",
    "FirstName": "BALASUBRAMANIAM",
    "MiddleName": "S",
    "NamePrefix": "DR.",
    "NameSuffix": null,
    "Credential": "MD",
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": "IYER",
    "OtherFirstName": "B",
    "OtherMiddleName": "S",
    "OtherNamePrefix": "DR.",
    "OtherNameSuffix": null,
    "OtherCredential": null,
    "OtherLastNameTypeCode": "2",
    "FirstLineMailingAddress": "1945 W WILSON AVENUE",
    "SecondLineMailingAddress": "SUITE #2115",
    "MailingAddressCityName": "CHICAGO",
    "MailingAddressStateName": "IL",
    "MailingAddressPostalCode": "60640-5255",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "773-878-5225",
    "MailingAddressFaxNumber": "773-878-5661",
    "FirstLinePracticeLocationAddress": "1945 W WILSON AVENUE",
    "SecondLinePracticeLocationAddress": "SUITE #2115",
    "PracticeLocationAddressCityName": "CHICAGO",
    "PracticeLocationAddressStateName": "IL",
    "PracticeLocationAddressPostalCode": "60640-5255",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "773-878-5225",
    "PracticeLocationAddressFaxNumber": "773-878-5661",
    "EnumerationDate": "02/21/2007",
    "LastUpdateDate": "04/21/2010",
    "NPIDeactivationReasonCode": null,
    "NPIDeactivationReason": null,
    "NPIDeactivationDate": null,
    "NPIReactivationDate": null,
    "GenderCode": "M",
    "Gender": "Male",
    "AuthorizedOfficialLastName": null,
    "AuthorizedOfficialFirstName": null,
    "AuthorizedOfficialMiddleName": null,
    "AuthorizedOfficialTitle": null,
    "AuthorizedOfficialNamePrefix": null,
    "AuthorizedOfficialNameSuffix": null,
    "AuthorizedOfficialCredential": null,
    "AuthorizedOfficialTelephoneNumber": null,
    "Taxonomies": {
      "Taxonomy": [
        {
          "TaxonomyCode": "2086S0129X",
          "TaxonomyName": "Vascular Surgery Physician",
          "LicenseNumber": "036046165",
          "LicenseNumberStateCode": "IL",
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "208G00000X",
          "TaxonomyName": "Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician",
          "LicenseNumber": "036046165",
          "LicenseNumberStateCode": "IL",
          "PrimaryTaxonomySwitch": "Y"
        }
      ]
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}
                
            

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