Provider Demographics
NPI:1952498248
Name:SARMA, VIJAYA K (MD,)
Entity Type:Individual
Prefix:DR
First Name:VIJAYA
Middle Name:K
Last Name:SARMA
Suffix:
Gender:F
Credentials:MD,
Other - Prefix:
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Mailing Address - Street 1:8541 S STATE ST
Mailing Address - Street 2:STE#9
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60619-5665
Mailing Address - Country:US
Mailing Address - Phone:773-488-2595
Mailing Address - Fax:774-783-8561
Practice Address - Street 1:8541 S STATE ST
Practice Address - Street 2:STE#9
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60619-5665
Practice Address - Country:US
Practice Address - Phone:773-488-2595
Practice Address - Fax:774-783-8561
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
IL036099712207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL036099712Medicaid
IL036099712Medicaid
H01032Medicare UPIN