Provider Demographics
NPI:1639345598
Name:HARSHA VARDHAN, SINDHUJA (MD)
Entity Type:Individual
Prefix:
First Name:SINDHUJA
Middle Name:
Last Name:HARSHA VARDHAN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:SINDHUJA
Other - Middle Name:
Other - Last Name:KANNAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:910 S MICHIGAN AVE
Mailing Address - Street 2:APARTMENT 1215
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60605-2356
Mailing Address - Country:US
Mailing Address - Phone:312-413-9589
Mailing Address - Fax:312-996-8204
Practice Address - Street 1:1801 W TAYLOR ST
Practice Address - Street 2:SUITE 2E
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60612-4795
Practice Address - Country:US
Practice Address - Phone:312-996-7416
Practice Address - Fax:312-413-8778
Is Sole Proprietor?:No
Enumeration Date:2008-05-01
Last Update Date:2016-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL0361276842080P0214X, 2080P0214X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080P0214XAllopathic & Osteopathic PhysiciansPediatricsPediatric Pulmonology