Provider Demographics
NPI:1164696209
Name:KONDA, VANI J ALBERTSON (MD)
Entity Type:Individual
Prefix:DR
First Name:VANI
Middle Name:J ALBERTSON
Last Name:KONDA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:VANI
Other - Middle Name:JANARDHAN
Other - Last Name:KONDA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:5841 S MARYLAND AVE
Mailing Address - Street 2:MC 4076
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60637-1447
Mailing Address - Country:US
Mailing Address - Phone:773-834-1370
Mailing Address - Fax:
Practice Address - Street 1:5841 S MARYLAND AVE
Practice Address - Street 2:MC 4076
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60637-1447
Practice Address - Country:US
Practice Address - Phone:773-834-1370
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-04-18
Last Update Date:2022-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036-113090207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology