Individual provider Active NPI

Virendra Bisla, MD

  • Internal Medicine Physician
  • Chicago, IL
National Provider Identifier
1073682910
Registry record updated Jul 29, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
036047792 Issued in IL
Practice address
9011 S Commercial Ave
Chicago, IL 60617-4304
Phone
(773) 933-0700
NPI assigned
Nov 7, 2006
Last updated
Jul 29, 2008By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 29, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 036047792 IL Primary

Addresses

Primary practice location

9011 S Commercial Ave
Chicago, IL 60617-4304

Mailing address

541 Otis Bowen Dr
Munster, IN 46321-4158
Phone (219) 934-5300

Other identifiers 1

IdentifierTypeStateIssuer
036047792MedicaidIL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080715000778 IL Practitioner - Internal Medicine 1153322714 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 1970
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

9011 S Commercial Ave
Chicago, IL 60617-4304
Phone (773) 933-0700

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
036047792ILMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Barisura Private LTD CurrentSince Jan 1, 1996 Accepting new patients
Heart Care Centers of South Chicago, LTD Internal Medicine CurrentSince Apr 1, 2008 Accepting new patients

Locations

9011 S Commercial Ave
Chicago, IL 60617
Phone (773) 933-0700

9410 Compubill Dr
Orland Park, IL 60462
Phone (312) 460-7444

541 Otis Bowen Dr
Munster, IN 46321

Organizations & group practices 3

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

Hospital & facility affiliations 5

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1162857600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1217289600000",
    "number": "1073682910",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "541 OTIS BOWEN DR",
            "city": "MUNSTER",
            "state": "IN",
            "postal_code": "463214158",
            "telephone_number": "219-934-5300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9011 S COMMERCIAL AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606174304",
            "telephone_number": "773-933-0700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BISLA",
        "first_name": "VIRENDRA",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-07",
        "last_updated": "2008-07-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "IL",
            "license": "036047792",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036047792",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.