Provider Demographics
NPI:1568435055
Name:AHER, VIJAY (MD)
Entity Type:Individual
Prefix:
First Name:VIJAY
Middle Name:
Last Name:AHER
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 1:1618 S EUGENE LN
Mailing Address - Street 2:
Mailing Address - City:MARION
Mailing Address - State:IL
Mailing Address - Zip Code:62959-1554
Mailing Address - Country:US
Mailing Address - Phone:618-558-5956
Mailing Address - Fax:
Practice Address - Street 1:3331 W DEYOUNG ST
Practice Address - Street 2:SUITE105
Practice Address - City:MARION
Practice Address - State:IL
Practice Address - Zip Code:62959-5896
Practice Address - Country:US
Practice Address - Phone:618-997-9496
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-02-07
Last Update Date:2013-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA35758208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208800000XAllopathic & Osteopathic PhysiciansUrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL036066669Medicaid
IL207988OtherMED GRP NUMBER
IL6132045OtherBCBS OF ILLINOIS
ILCE9335OtherRR GRP NUMBER
IA0443341Medicaid
IA37216OtherBLUE CROSS BLUE SHIELD
IA512435OtherIOWA HEALTH SOLUTIONS
IAIA0140OtherJOHN DEERE HEALTH
IAP00145519OtherRAILROAD MEDICARE
ILP00440224OtherRR MED NUMBER
ILCE9335OtherRR GRP NUMBER
IL207988OtherMED GRP NUMBER
IA37216OtherBLUE CROSS BLUE SHIELD