NPIMap

Organization Active NPI

Innovative Vascular and Therapeutics, PLLC

  • Vascular & Interventional Radiology Physician
  • Oak Park, IL
National Provider Identifier
1386291664
Registry record updated May 8, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Vascular & Interventional Radiology PhysicianTaxonomy code 2085R0204X
Legal business name
INNOVATIVE VASCULAR AND THERAPEUTICS, PLLC
Practice address
1515 N Harlem Ave Ste 100
Oak Park, IL 60302-1205
Phone
(401) 575-0308
Fax
(562) 548-7540
NPI assigned
Aug 21, 2019
Last updated
May 8, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 8, 2023

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

Authorized official

Name
Dr. Malwinder Singh Singha, MDNPI 1972558203
Title
President
Phone
(401) 575-0308

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 4

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X NU
Vascular & Interventional Radiology Physician 2085R0204X NU Primary
Vascular Surgery Physician 2086S0129X NU
Certified Registered Nurse Anesthetist 367500000X NU

Addresses

Primary practice location

1515 N Harlem Ave Ste 100
Oak Park, IL 60302-1205

Mailing address

PO Box 379
Pasadena, CA 91102-0379
Phone (401) 575-0308

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20200827002235 IL Part B Supplier - Clinic/Group Practice 3779900378 Receives reassigned benefits from 7 practitioners
Practice locations: Chicago, IL; Elk Grove Village, IL; Oak Park, IL

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
14D2177859Innovative Vascular & Therapeutics, P L L C1515 N Harlem Ave - Ste 100, Oak Park, IL 60302AccreditationJun 29, 2027

National Provider Directory

National Provider Directory

Locations

3115 N Harlem Ave
Ste 200
Chicago, IL 60634
Phone (773) 637-6070

1515 N Harlem Ave
Ste 111
Oak Park, IL 60302
Phone (401) 575-0308

Practitioners & affiliated clinicians

Practitioners 9

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1566345600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1683504000000",
    "number": "1386291664",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 379",
            "city": "PASADENA",
            "state": "CA",
            "postal_code": "911020379",
            "telephone_number": "401-575-0308",
            "fax_number": "562-548-7540"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1515 N HARLEM AVE STE 100",
            "city": "OAK PARK",
            "state": "IL",
            "postal_code": "603021205",
            "telephone_number": "401-575-0308",
            "fax_number": "562-548-7540"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INNOVATIVE VASCULAR AND THERAPEUTICS, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-08-21",
        "last_updated": "2023-05-08",
        "certification_date": "2023-05-08",
        "status": "A",
        "authorized_official_last_name": "SINGHA",
        "authorized_official_first_name": "MALWINDER",
        "authorized_official_middle_name": "SINGH",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "401-575-0308",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "2085R0204X",
            "taxonomy_group": "",
            "desc": "Radiology, Vascular & Interventional Radiology",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "2086S0129X",
            "taxonomy_group": "",
            "desc": "Surgery, Vascular Surgery",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Oak Park, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 8, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.