Active NPI
Vidya Sriram
- Anatomic Pathology & Clinical Pathology Physician
- Melrose Park, IL
National Provider Identifier
1922104967
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Anatomic Pathology & Clinical Pathology Physician
- License
- 036081251
- Practice address
- 1225 W Lake St
Melrose Park, IL 60160-4039 - Phone
- (708) 938-7607
- NPI assigned
- Sep 16, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Anatomic Pathology & Clinical Pathology Physician | 207ZP0102X | 036081251 | IL | Primary |
Addresses
Primary practice location
1225 W Lake St
Melrose Park, IL 60160-4039
Mailing address
PO Box 2486
Indianapolis, IN 46206-2486
Other identifiers 4
| Identifier | Type | State | Issuer |
|---|---|---|---|
| P00032904 | Other | RAILROAD MEDICARE | |
| 36412532002 | Other | CHAMPUS | |
| 01621061 | Other | IL | BCBS IL |
| 036081251 | Medicaid | IL |
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
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Pathology CHP, SC | Anatomic Pathology & Clinical Pathology | Past | Accepting new patients |
| Diagnostic Pathology Consultants, SC | Past | Accepting new patients |
Organizations & group practices 2
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.
-
- Anatomic Pathology Physician
- Melrose Park, IL
- NPI 1437329505
-
- Anatomic Pathology & Clinical Pathology Physician
- Chicago, IL
- NPI 1952407256
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1158364800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1252368000000",
"number": "1922104967",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 2486",
"city": "INDIANAPOLIS",
"state": "IN",
"postal_code": "462062486"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1225 W LAKE ST",
"city": "MELROSE PARK",
"state": "IL",
"postal_code": "601604039",
"telephone_number": "708-938-7607"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SRIRAM",
"first_name": "VIDYA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-09-16",
"last_updated": "2009-09-08",
"status": "A"
},
"taxonomies": [
{
"code": "207ZP0102X",
"taxonomy_group": "",
"desc": "Pathology, Anatomic Pathology & Clinical Pathology",
"state": "IL",
"license": "036081251",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RAILROAD MEDICARE",
"identifier": "P00032904",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CHAMPUS",
"identifier": "36412532002",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS IL",
"identifier": "01621061",
"state": "IL"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "036081251",
"state": "IL"
}
],
"endpoints": [],
"other_names": []
}Other providers in Melrose Park, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 8, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.