Bhavana Vaidya MD LLC

Primary specialty

Pain Medicine (Physical Medicine & Rehabilitation) PhysicianTaxonomy code 2081P2900X

License

036066303 Issued in IL

Legal business name

BHAVANA VAIDYA MD LLC

Practice address

10601 S Kilbourn Ave
Oak Lawn, IL 60453-5341

Phone

(773) 962-4025

NPI assigned

Apr 4, 2014

Organization subpart

No

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

Authorized official

Name

Bhavana Vaidya

Title

MD

Phone

(773) 962-4025

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1396569600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1593475200000",
    "number": "1992123004",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10601 S KILBOURN AVE",
            "city": "OAK LAWN",
            "state": "IL",
            "postal_code": "604535341",
            "telephone_number": "773-962-4025"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10601 S KILBOURN AVE",
            "city": "OAK LAWN",
            "state": "IL",
            "postal_code": "604535341",
            "telephone_number": "773-962-4025"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BHAVANA VAIDYA MD LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-04-04",
        "last_updated": "2020-06-30",
        "certification_date": "2020-06-30",
        "status": "A",
        "authorized_official_last_name": "VAIDYA",
        "authorized_official_first_name": "BHAVANA",
        "authorized_official_title_or_position": "MD",
        "authorized_official_telephone_number": "773-962-4025"
    },
    "taxonomies": [
        {
            "code": "2081P2900X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Medicine & Rehabilitation, Pain Medicine",
            "state": "IL",
            "license": "036066303",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Pain Medicine (Physical Medicine & Rehabilitation) Physician in Oak Lawn, IL
• Providers in Oak Lawn, IL by specialty
• Pain Medicine (Physical Medicine & Rehabilitation) Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 30, 2020; 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.