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NPI Code Detail

MEDICARE: PRAVIR BAXI M.D.

MEDICARE: PRAVIR BAXI 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
1207RN0300XNephrology Physician036135424IL

General Provider Information

NPI Number : 1780970731
Entity Type Code : Individual
Provider Name (Legal Business Name) : PRAVIR BAXI M.D.
Provider Business Mailing Address
First Line : 120 W 22ND ST
Second Line :
City : OAK BROOK
State : IL
Zip : 60523-1557
Country : US
Telephone Number : 630-573-5000
Fax Number : 630-368-0280
Provider Business Practice Location Address
First Line : 104 S ASHLAND AVE
Second Line :
City : CHICAGO
State : IL
Zip : 60607-2402
Country : US
Telephone Number : 312-850-8434
Fax Number : 312-850-8431
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/28/2011
Last Update Date : 04/29/2025

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Directions to “ PRAVIR BAXI M.D.” Practice Location

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