Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207QA0401X | Family Doctor - Addiction Medicine | 036069638 | IL |
NPI | 1558736512 |
---|---|
Provider Name | Dr. Hemlata P Vaidya |
First Address | Chicago, IL 60609-1317 |
Second Address | Chicago, IL 60609-1317 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 02/12/2015 |
Last Update Date | 28/03/2018 |