Individual provider Active NPI

Vasim Raja Panwar

  • Dentist
  • Chicago, IL
National Provider Identifier
1013694736
Registry record updated Jul 28, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
019037000 Issued in IL
Practice address
3435 W Irving Park Rd
Chicago, IL 60618-3217
Phone
(773) 588-8200
NPI assigned
Jul 4, 2023
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 28, 2026

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
DentistGroup: 193400000X SINGLE SPECIALTY GROUP 122300000X 019037000 IL Primary

Addresses

Primary practice location

3435 W Irving Park Rd
Chicago, IL 60618-3217

Mailing address

502 Midwest Club Pkwy
Oak Brook, IL 60523-2529
Phone (773) 923-5231

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Nova Southeastern University, Inc PastSince Jul 9, 2023 Accepting new patients
Irving Park Family Dentist Dentist PastSince Oct 12, 2025 Accepting new patients

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1688428800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1785196800000",
    "number": "1013694736",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "502 MIDWEST CLUB PKWY",
            "city": "OAK BROOK",
            "state": "IL",
            "postal_code": "605232529",
            "telephone_number": "773-923-5231"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3435 W IRVING PARK RD",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606183217",
            "telephone_number": "773-588-8200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PANWAR",
        "first_name": "VASIM",
        "middle_name": "RAJA",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2023-07-04",
        "last_updated": "2026-07-28",
        "certification_date": "2026-07-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": "IL",
            "license": "019037000",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 28, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.