Provider Demographics
NPI:1013132455
Name:VIJAY H. VOHRA M.D.,S.C.
Entity type:Organization
Organization Name:VIJAY H. VOHRA M.D.,S.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:VIJAY
Authorized Official - Middle Name:H
Authorized Official - Last Name:VOHRA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:773-774-5245
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
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-13
Last Update Date:2008-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular DiseaseGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL21606541OtherBLUE CROSS BLUE SHIELD
IL21606541OtherBLUE CROSS BLUE SHIELD
ILDA1033Medicare PIN