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NPI Code Detail

MEDICARE: DR. YAGNESH V. OZA M.D.

MEDICARE: DR. YAGNESH V. OZA 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
1207RH0003XHematology & Oncology PhysicianIL

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
14100068OTHERILBLUE CROSS BLUE SHIELD

General Provider Information

NPI Number : 1912984766
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. YAGNESH V. OZA M.D.
Provider Business Mailing Address
First Line : 14995 N..42ND ST
Second Line :
City : MT. VERNON
State : IL
Zip : 62864
Country : US
Telephone Number : 618-242-6484
Fax Number :
Provider Business Practice Location Address
First Line : 4117 VETERANS MEMORIAL DR
Second Line :
City : MOUNT VERNON
State : IL
Zip : 62864-6262
Country : US
Telephone Number : 618-244-6500
Fax Number : 618-244-6422
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/22/2005
Last Update Date : 07/09/2007

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