Provider Demographics
NPI:1740382779
Name:JOSHI, MAYA KIRIT (MD)
Entity Type:Individual
Prefix:
First Name:MAYA
Middle Name:KIRIT
Last Name:JOSHI
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:7024 N KILPATRICK AVE
Mailing Address - Street 2:
Mailing Address - City:LINCOLNWOOD
Mailing Address - State:IL
Mailing Address - Zip Code:60712
Mailing Address - Country:US
Mailing Address - Phone:773-784-1199
Mailing Address - Fax:847-982-2877
Practice Address - Street 1:5214 N WESTERN AVE
Practice Address - Street 2:FOSTER WESTERN MEDICAL CENTER
Practice Address - City:LINCOLNWOOD
Practice Address - State:IL
Practice Address - Zip Code:60625
Practice Address - Country:US
Practice Address - Phone:773-784-1199
Practice Address - Fax:847-982-2877
Is Sole Proprietor?:No
Enumeration Date:2006-09-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
ILD15989Medicare UPIN