Provider Demographics
NPI:1710212733
Name:VASCULAR SURGERY AND INTERPRETATION S.C.
Entity Type:Organization
Organization Name:VASCULAR SURGERY AND INTERPRETATION S.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:K
Authorized Official - Middle Name:RAMESH
Authorized Official - Last Name:ADIGA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:708-647-6180
Mailing Address - Street 1:3330 W 177TH ST STE 2C1
Mailing Address - Street 2:
Mailing Address - City:HAZEL CREST
Mailing Address - State:IL
Mailing Address - Zip Code:60429-2184
Mailing Address - Country:US
Mailing Address - Phone:708-647-6180
Mailing Address - Fax:
Practice Address - Street 1:3330 W 177TH ST STE 2C1
Practice Address - Street 2:
Practice Address - City:HAZEL CREST
Practice Address - State:IL
Practice Address - Zip Code:60429-2184
Practice Address - Country:US
Practice Address - Phone:708-647-6180
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-10-08
Last Update Date:2009-10-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL0360427802086S0129X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2086S0129XAllopathic & Osteopathic PhysiciansSurgeryVascular SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
ILK49130Medicare PIN