MEDICARE: VINAY RAWLANI 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
1	2086S0122X	Plastic and Reconstructive Surgery Physician	036.129223	IL
2	2086S0122X	Plastic and Reconstructive Surgery Physician	125055900	IL

General Provider Information

NPI Number	:	1770817868
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	VINAY RAWLANI MD

Provider Business Mailing Address
First Line	:	1436 S PRAIRIE AVE UNIT B
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60605-3356
Country	:	US
Telephone Number	:	815-351-2801
Fax Number	:

Provider Business Practice Location Address
First Line	:	1436 S PRAIRIE AVE UNIT B
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60605-3356
Country	:	US
Telephone Number	:	815-351-2801
Fax Number	:

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

Provider Enumeration Date	:	09/23/2009
Last Update Date	:	03/19/2024

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