Individual provider Active NPI

Bhupinder K. Valia, M.D.

  • Internal Medicine Physician
  • South Holland, IL
National Provider Identifier
1194724872
Registry record updated Aug 14, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
036071717 Issued in IL
Practice address
16115 La Salle St
South Holland, IL 60473-2064
Phone
(708) 331-8830
Fax
(708) 331-8860
NPI assigned
Jul 15, 2005
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 14, 2015

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 036071717 IL Primary

Addresses

Primary practice location

16115 La Salle St
South Holland, IL 60473-2064

Mailing address

16115 La Salle St
South Holland, IL 60473-2064
Phone (708) 331-8830

Other identifiers 1

IdentifierTypeStateIssuer
036071717MedicaidIL

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)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
036071717ILMDInternal Medicine Physician

NPI Registry JSON

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

{
    "created_epoch": "1121385600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1439510400000",
    "number": "1194724872",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16115 LA SALLE ST",
            "city": "SOUTH HOLLAND",
            "state": "IL",
            "postal_code": "604732064",
            "telephone_number": "708-331-8830",
            "fax_number": "708-331-8860"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16115 LA SALLE ST",
            "city": "SOUTH HOLLAND",
            "state": "IL",
            "postal_code": "604732064",
            "telephone_number": "708-331-8830",
            "fax_number": "708-331-8860"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VALIA",
        "first_name": "BHUPINDER",
        "middle_name": "K.",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2005-07-15",
        "last_updated": "2015-08-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "IL",
            "license": "036071717",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036071717",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in South Holland, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 14, 2015; 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.