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NPI Code Detail

MEDICARE: PRIYA VERGHESE MD

MEDICARE: PRIYA VERGHESE 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
12080P0210XPediatric Nephrology Physician036151383IL
2208000000XPediatrics Physician036151383IL

General Provider Information

NPI Number : 1902917891
Entity Type Code : Individual
Provider Name (Legal Business Name) : PRIYA VERGHESE MD
Provider Business Mailing Address
First Line : 225 E CHICAGO AVE
Second Line :
City : CHICAGO
State : IL
Zip : 60611-2991
Country : US
Telephone Number : 800-543-7362
Fax Number :
Provider Business Practice Location Address
First Line : 225 E CHICAGO AVE
Second Line :
City : CHICAGO
State : IL
Zip : 60611-2991
Country : US
Telephone Number : 800-543-7362
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/31/2006
Last Update Date : 12/02/2025

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