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NPI Code Detail

MEDICARE: DR. PANKAJ G VASHI M.D.

MEDICARE: DR. PANKAJ G VASHI 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
1207RG0100XGastroenterology Physician036-083762IL
2207RG0100XGastroenterology Physician036.083762IL

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
104901168OTHERILBCBS
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1336136258
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. PANKAJ G VASHI M.D.
Provider Business Mailing Address
First Line : 2520 ELISHA AVE
Second Line :
City : ZION
State : IL
Zip : 60099
Country : US
Telephone Number : 847-872-4561
Fax Number : 847-263-5459
Provider Business Practice Location Address
First Line : 2520 ELISHA AVE
Second Line :
City : ZION
State : IL
Zip : 60099-2676
Country : US
Telephone Number : 847-872-6415
Fax Number : 847-746-6007
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/05/2005
Last Update Date : 01/07/2024

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