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NPI Code Detail

MEDICARE: DR. HEMLATA P VAIDYA MD

MEDICARE: DR. HEMLATA P VAIDYA MD
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
1207QA0401XAddiction Medicine (Family Medicine) Physician036069638IL

General Provider Information

NPI Number : 1558736512
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. HEMLATA P VAIDYA MD
Provider Business Mailing Address
First Line : 3520 S ASHLAND AVE
Second Line :
City : CHICAGO
State : IL
Zip : 60609-1317
Country : US
Telephone Number : 773-523-3400
Fax Number :
Provider Business Practice Location Address
First Line : 3520 S ASHLAND AVE
Second Line :
City : CHICAGO
State : IL
Zip : 60609-1317
Country : US
Telephone Number : 773-523-3400
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/02/2015
Last Update Date : 03/28/2018

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Directions to “ DR. HEMLATA P VAIDYA MD” Practice Location

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