Provider Demographics
NPI:1952963191
Name:VORA, MINAXI H
Entity type:Individual
Prefix:
First Name:MINAXI
Middle Name:H
Last Name:VORA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:415 FRANKFORT AVE
Mailing Address - Street 2:
Mailing Address - City:OSWEGO
Mailing Address - State:IL
Mailing Address - Zip Code:60543-7756
Mailing Address - Country:US
Mailing Address - Phone:630-800-0279
Mailing Address - Fax:
Practice Address - Street 1:415 FRANKFORT AVE
Practice Address - Street 2:
Practice Address - City:OSWEGO
Practice Address - State:IL
Practice Address - Zip Code:60543-7756
Practice Address - Country:US
Practice Address - Phone:630-800-0279
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-07-08
Last Update Date:2019-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program