Active NPI
Vyas Harshavadan J MD
- Obstetrics & Gynecology Physician
- Ottawa, IL
National Provider Identifier
1114290244
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Obstetrics & Gynecology Physician
- License
- 036071120
- Legal business name
- VYAS HARSHAVADAN J MD
- Practice address
- 1013 Clinton St
Ottawa, IL 61350-2039 - Phone
- (815) 433-3331
- Fax
- (815) 433-3344
- NPI assigned
- Feb 21, 2012
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Dr. Harshavadan J Vyas, M.D..
- Title
- Physician/Owner
- Phone
- (815) 433-3331
Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Obstetrics & Gynecology Physician | 207V00000X | 036071120 | IL | Primary |
Addresses
Primary practice location
1013 Clinton St
Ottawa, IL 61350-2039
Mailing address
1013 Clinton St
Ottawa, IL 61350-2039
Phone (815) 433-3331
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 036071120 | Medicaid | IL | |
| 500034350 | Other | IL | BLUECROSS BLUE SHIELD PROVIDER ID |
National Provider Directory
National Provider DirectoryLocations
1013 Clinton St
Ottawa, IL 61350
Phone (815) 433-3331
Practitioners & affiliated clinicians
Practitioners 1
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Obstetrics & Gynecology Physician
- Ottawa, IL
- NPI 1841391950
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1329782400000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1329782400000",
"number": "1114290244",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1013 CLINTON ST",
"city": "OTTAWA",
"state": "IL",
"postal_code": "613502039",
"telephone_number": "815-433-3331",
"fax_number": "815-433-3344"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1013 CLINTON ST",
"city": "OTTAWA",
"state": "IL",
"postal_code": "613502039",
"telephone_number": "815-433-3331",
"fax_number": "815-433-3344"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "VYAS HARSHAVADAN J MD",
"organizational_subpart": "NO",
"enumeration_date": "2012-02-21",
"last_updated": "2012-02-21",
"status": "A",
"authorized_official_last_name": "VYAS",
"authorized_official_first_name": "HARSHAVADAN",
"authorized_official_middle_name": "J",
"authorized_official_title_or_position": "PHYSICIAN/OWNER",
"authorized_official_telephone_number": "815-433-3331",
"authorized_official_name_prefix": "Dr.",
"authorized_official_credential": "M.D.."
},
"taxonomies": [
{
"code": "207V00000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Obstetrics & Gynecology",
"state": "IL",
"license": "036071120",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "036071120",
"state": "IL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUECROSS BLUE SHIELD PROVIDER ID",
"identifier": "500034350",
"state": "IL"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Ottawa, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 21, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.