Provider Demographics
NPI:1306045646
Name:LANDERAS, VEEDA O (MD)
Entity Type:Individual
Prefix:
First Name:VEEDA
Middle Name:O
Last Name:LANDERAS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:VEEDA
Other - Middle Name:O
Other - Last Name:QUTEISH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:210 S DES PLAINES ST
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60661-5500
Mailing Address - Country:US
Mailing Address - Phone:312-654-2700
Mailing Address - Fax:312-654-9930
Practice Address - Street 1:2740 W FOSTER AVE STE 207
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60625-3526
Practice Address - Country:US
Practice Address - Phone:773-820-8502
Practice Address - Fax:773-716-3712
Is Sole Proprietor?:No
Enumeration Date:2007-07-17
Last Update Date:2024-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036144328207RN0300X
OH35090186207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL036144328Medicaid
OHQU2029361Medicare PIN
OH2767466Medicaid