Provider Demographics
NPI:1508997982
Name:BAJAJ, VIJAY (MD)
Entity Type:Individual
Prefix:DR
First Name:VIJAY
Middle Name:
Last Name:BAJAJ
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10401 S ROBERTS RD
Mailing Address - Street 2:SUITE 1,
Mailing Address - City:PALOS HILLS
Mailing Address - State:IL
Mailing Address - Zip Code:60465-1991
Mailing Address - Country:US
Mailing Address - Phone:708-598-4430
Mailing Address - Fax:708-598-4478
Practice Address - Street 1:10401 S ROBERTS RD
Practice Address - Street 2:SUITE 1,
Practice Address - City:PALOS HILLS
Practice Address - State:IL
Practice Address - Zip Code:60465-1991
Practice Address - Country:US
Practice Address - Phone:708-598-4430
Practice Address - Fax:708-598-4478
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-08
Last Update Date:2023-03-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036058299207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL695040Medicare ID - Type Unspecified
ILC45730Medicare UPIN