MEDICARE: DR. BHUPINDER K. VALIA M.D.

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
1	207R00000X	Internal Medicine Physician	036071717	IL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1194724872
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. BHUPINDER K. VALIA M.D.

Provider Business Mailing Address
First Line	:	16115 LA SALLE ST
Second Line	:
City	:	SOUTH HOLLAND
State	:	IL
Zip	:	60473-2064
Country	:	US
Telephone Number	:	708-331-8830
Fax Number	:	708-331-8860

Provider Business Practice Location Address
First Line	:	16115 LA SALLE ST
Second Line	:
City	:	SOUTH HOLLAND
State	:	IL
Zip	:	60473-2064
Country	:	US
Telephone Number	:	708-331-8830
Fax Number	:	708-331-8860

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/15/2005
Last Update Date	:	08/14/2015

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