MEDICARE: VISHNU JINDAL 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	208M00000X	Hospitalist Physician	036105333	IL
2	207R00000X	Internal Medicine Physician	036105333	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	:	1851344766
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	VISHNU JINDAL M.D.

Provider Business Mailing Address
First Line	:	3880 SALEM LAKE DR
Second Line	:	STE F
City	:	LONG GROVE
State	:	IL
Zip	:	60047-6400
Country	:	US
Telephone Number	:	847-719-2220
Fax Number	:	847-719-2265

Provider Business Practice Location Address
First Line	:	3880 SALEM LAKE DR
Second Line	:	STE F
City	:	LONG GROVE
State	:	IL
Zip	:	60047-6400
Country	:	US
Telephone Number	:	847-719-2220
Fax Number	:	847-719-2265

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

Provider Enumeration Date	:	05/19/2006
Last Update Date	:	12/21/2021

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