Provider Demographics
NPI:1275941114
Name:V UPADHYAYA MD LTD
Entity Type:Organization
Organization Name:V UPADHYAYA MD LTD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:VARSHA
Authorized Official - Middle Name:V
Authorized Official - Last Name:UPADHYAYA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:708-636-6626
Mailing Address - Street 1:4400 W 95TH ST STE 202
Mailing Address - Street 2:
Mailing Address - City:OAK LAWN
Mailing Address - State:IL
Mailing Address - Zip Code:60453-2657
Mailing Address - Country:US
Mailing Address - Phone:708-636-6626
Mailing Address - Fax:708-658-6147
Practice Address - Street 1:4400 W 95TH ST STE 202
Practice Address - Street 2:
Practice Address - City:OAK LAWN
Practice Address - State:IL
Practice Address - Zip Code:60453-2657
Practice Address - Country:US
Practice Address - Phone:708-636-6626
Practice Address - Fax:708-658-6147
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-07-23
Last Update Date:2014-09-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036057280207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Single Specialty