Provider Demographics
NPI:1134299779
Name:BARISURA PRIVATE LTD
Entity Type:Organization
Organization Name:BARISURA PRIVATE LTD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:VIRENDRA
Authorized Official - Middle Name:S
Authorized Official - Last Name:BISLA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:773-933-0700
Mailing Address - Street 1:9410 COMPUBILL DR
Mailing Address - Street 2:
Mailing Address - City:ORLAND PARK
Mailing Address - State:IL
Mailing Address - Zip Code:60462
Mailing Address - Country:US
Mailing Address - Phone:708-460-7444
Mailing Address - Fax:708-460-8662
Practice Address - Street 1:9011 S COMMERCIAL AVE
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60617
Practice Address - Country:US
Practice Address - Phone:773-933-0700
Practice Address - Fax:773-933-7407
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-09
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Not Answered207U00000XAllopathic & Osteopathic PhysiciansNuclear MedicineGroup - Single Specialty
Not Answered207UN0901XAllopathic & Osteopathic PhysiciansNuclear MedicineNuclear CardiologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
212400Medicare ID - Type Unspecified
C41917Medicare UPIN