Provider Demographics
NPI:1922085695
Name:VORA, MAHIM K (MD)
Entity Type:Individual
Prefix:
First Name:MAHIM
Middle Name:K
Last Name:VORA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:112 SADDLEBROOK DRIVE
Mailing Address - Street 2:
Mailing Address - City:OAKBROOK
Mailing Address - State:IL
Mailing Address - Zip Code:60523
Mailing Address - Country:US
Mailing Address - Phone:708-535-1333
Mailing Address - Fax:708-535-1777
Practice Address - Street 1:3235 VOLLMER ROAD
Practice Address - Street 2:SUITE 119
Practice Address - City:FLOSSMOOR
Practice Address - State:IL
Practice Address - Zip Code:60426
Practice Address - Country:US
Practice Address - Phone:708-754-8815
Practice Address - Fax:708-798-1315
Is Sole Proprietor?:Yes
Enumeration Date:2005-12-23
Last Update Date:2014-07-16
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
IL0360581262084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL036058126Medicaid
B29319Medicare UPIN
IL036058126Medicaid