Provider Demographics
NPI:1467222919
Name:FIRSTMDVIP
Entity Type:Organization
Organization Name:FIRSTMDVIP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:RANJIT
Authorized Official - Middle Name:K
Authorized Official - Last Name:DHELARIA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:682-235-0825
Mailing Address - Street 1:222 W ONTARIO ST STE 230
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60654-3653
Mailing Address - Country:US
Mailing Address - Phone:312-772-5040
Mailing Address - Fax:
Practice Address - Street 1:222 W ONTARIO ST STE 230
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60654-3653
Practice Address - Country:US
Practice Address - Phone:312-772-5040
Practice Address - Fax:248-294-1235
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-01-05
Last Update Date:2024-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty