Provider Demographics
NPI:1740511252
Name:VYAS KHANDAN LLC
Entity type:Organization
Organization Name:VYAS KHANDAN LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:MANAGING MEMBER
Authorized Official - Prefix:DR
Authorized Official - First Name:PRANAV
Authorized Official - Middle Name:PANKAJ
Authorized Official - Last Name:VYAS
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:847-550-6500
Mailing Address - Street 1:755 ELA RD STE B
Mailing Address - Street 2:
Mailing Address - City:LAKE ZURICH
Mailing Address - State:IL
Mailing Address - Zip Code:60047-2412
Mailing Address - Country:US
Mailing Address - Phone:847-550-6500
Mailing Address - Fax:847-550-6595
Practice Address - Street 1:755 ELA RD STE B
Practice Address - Street 2:
Practice Address - City:LAKE ZURICH
Practice Address - State:IL
Practice Address - Zip Code:60047-2412
Practice Address - Country:US
Practice Address - Phone:847-550-6500
Practice Address - Fax:847-550-6595
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-01-22
Last Update Date:2024-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty