Provider Demographics
NPI:1770817868
Name:RAWLANI, VINAY (MD)
Entity type:Individual
Prefix:
First Name:VINAY
Middle Name:
Last Name:RAWLANI
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 1:1436 S PRAIRIE AVE UNIT B
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60605-3356
Mailing Address - Country:US
Mailing Address - Phone:815-351-2801
Mailing Address - Fax:
Practice Address - Street 1:1436 S PRAIRIE AVE UNIT B
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60605-3356
Practice Address - Country:US
Practice Address - Phone:815-351-2801
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-09-23
Last Update Date:2024-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036.1292232086S0122X
IL1250559002086S0122X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2086S0122XAllopathic & Osteopathic PhysiciansSurgeryPlastic and Reconstructive Surgery