Provider Demographics
NPI:1669486635
Name:VRAJ, LTD
Entity Type:Organization
Organization Name:VRAJ, LTD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:NARESH
Authorized Official - Middle Name:K
Authorized Official - Last Name:UPADHYAY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:219-852-0197
Mailing Address - Street 1:10547 MISTY HILL RD
Mailing Address - Street 2:
Mailing Address - City:ORLAND PARK
Mailing Address - State:IL
Mailing Address - Zip Code:60462-7439
Mailing Address - Country:US
Mailing Address - Phone:219-852-0197
Mailing Address - Fax:219-937-2195
Practice Address - Street 1:2315 E 93RD ST STE 237
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60617-3919
Practice Address - Country:US
Practice Address - Phone:847-768-8925
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-28
Last Update Date:2023-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036083179207RC0200X, 207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary DiseaseGroup - Multi-Specialty
No207RC0200XAllopathic & Osteopathic PhysiciansInternal MedicineCritical Care MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL01606600OtherBLUE CROSS/SHIELD
ILK36165OtherMEDICARE INDIVIDUAL PIN
IN000095707OtherANTHEM
ILK36165OtherMEDICARE INDIVIDUAL PIN
IN253270AOtherMEDICARE INDIVIDUAL PIN
IN000095707OtherANTHEM
IL01606600OtherBLUE CROSS/SHIELD
IN200066830AMedicaid
IL01606600OtherBLUE CROSS/SHIELD