Provider Demographics
NPI:1891797379
Name:VOHRA, VIJAY H (MD)
Entity Type:Individual
Prefix:
First Name:VIJAY
Middle Name:H
Last Name:VOHRA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7447 W TALCOTT AVE
Mailing Address - Street 2:SUITE 222
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60631-3745
Mailing Address - Country:US
Mailing Address - Phone:773-774-5245
Mailing Address - Fax:773-774-8580
Practice Address - Street 1:7447 W TALCOTT AVE
Practice Address - Street 2:SUITE 222
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60631-3745
Practice Address - Country:US
Practice Address - Phone:773-774-5245
Practice Address - Fax:773-774-8580
Is Sole Proprietor?:No
Enumeration Date:2005-08-15
Last Update Date:2011-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036048369207R00000X, 207RC0000X, 207RI0011X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0011XAllopathic & Osteopathic PhysiciansInternal MedicineInterventional Cardiology
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL21606541OtherBLUE CROSS BLUE SHIELD
IL36048369Medicaid
IL21606541OtherBLUE CROSS BLUE SHIELD
IL36048369Medicaid