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NPI Code Detail

MEDICARE: UDAY I VYAS MD SC

MEDICARE: UDAY I VYAS MD SC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207RC0000XCardiovascular Disease Physician

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1712090OTHERILMEDICARE PROVIDER NUMBER

General Provider Information

NPI Number : 1104012061
Entity Type Code : Organization
Provider Name (Legal Business Name) : UDAY I VYAS MD SC
Provider Business Mailing Address
First Line : 7101 W HIGGINS AVE
Second Line :
City : CHICAGO
State : IL
Zip : 60656-1903
Country : US
Telephone Number : 773-792-9111
Fax Number : 773-792-9119
Provider Business Practice Location Address
First Line : 7101 W HIGGINS AVE
Second Line :
City : CHICAGO
State : IL
Zip : 60656-1903
Country : US
Telephone Number : 773-792-9111
Fax Number : 773-792-9119
Authorized Official
Title or Position : PRESIDENT
Name : DR. UDAY VYAS
Credential : MD
Telephone Number : 773-792-9111
Provider Enumeration Date : 09/24/2007
Last Update Date : 12/21/2007

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Directions to “UDAY I VYAS MD SC ” Practice Location

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