Provider Demographics
NPI:1164488763
Name:BAJAJ, VIMI (MD FACOG)
Entity Type:Individual
Prefix:DR
First Name:VIMI
Middle Name:
Last Name:BAJAJ
Suffix:
Gender:F
Credentials:MD FACOG
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 3754
Mailing Address - Street 2:
Mailing Address - City:OAK BROOK
Mailing Address - State:IL
Mailing Address - Zip Code:60522-3754
Mailing Address - Country:US
Mailing Address - Phone:630-428-1500
Mailing Address - Fax:630-428-3544
Practice Address - Street 1:640 SOUTH WASHINGTON ST
Practice Address - Street 2:STE 220
Practice Address - City:NAPERVILLE
Practice Address - State:IL
Practice Address - Zip Code:60540
Practice Address - Country:US
Practice Address - Phone:630-428-1500
Practice Address - Fax:630-428-3544
Is Sole Proprietor?:Yes
Enumeration Date:2006-04-22
Last Update Date:2012-05-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036089969207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL036068128Medicaid
IL036068128Medicaid
IL207285Medicare ID - Type Unspecified