Indira Vazzalwar, M.D.

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

License

036109022 Issued in IL

Practice address

1401 W. Dugdale Rd.
Waukegan, IL 60085

Phone

(847) 249-0600

Fax

(773) 262-1184

NPI assigned

Aug 3, 2005

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Indira Chirravuri Former name

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

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.

• Illinois Department of Human Services

  • Intellectual Disabilities Intermediate Care Facility
  • Centralia, IL
  • NPI 1003960394
  Medicare reassignment NPD
• Illinois Department of Human Services

  dba John J Madden Mental Health

  • Psychiatric Hospital
  • Hines, IL
  • NPI 1902903487
  NPD
• Illinois Department of Human Sevices

  • Intellectual Disabilities Intermediate Care Facility
  • Waukegan, IL
  • NPI 1679639967
  NPD
• Hamdard Health Alliance

  dba Hamdard Health Bensenville

  • Federally Qualified Health Center (FQHC)
  • Bensenville, IL
  • NPI 1700470580
  NPD (past)
• Prism Medical Center of Il NFP

  • Internal Medicine Physician
  • Chicago, IL
  • NPI 1023101086
  NPD (past)

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

{
    "created_epoch": "1123027200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1408665600000",
    "number": "1124029897",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6346 N TALMAN AVE",
            "address_2": "SUIT 102",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606591898",
            "telephone_number": "773-262-1300",
            "fax_number": "773-262-1184"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1401 W. DUGDALE RD.",
            "city": "WAUKEGAN",
            "state": "IL",
            "postal_code": "60085",
            "telephone_number": "847-249-0600",
            "fax_number": "773-262-1184"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VAZZALWAR",
        "first_name": "INDIRA",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-08-03",
        "last_updated": "2014-08-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "IL",
            "license": "036109022",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "INDIRA",
            "last_name": "CHIRRAVURI",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Claudia Elisabeth Vankoningsveld, BS, CADC
• Joshua Joel Vanpelt, MA, LCPC, CADC
• Jennyfer Andrea Vargas Gil
• Anca Sabrina Varvara-Piccozzi
• Hayley Vaughn
• Sully Vega
• Nathan James Vegter, NCC, CADC.
• Jocelyn Vela
• Camila Velasquez
• Norma Venable, LCPC

• Psychiatry Physician in Waukegan, IL
• Providers in Waukegan, IL by specialty
• Psychiatry Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.