Dr. Maitrayee Sundaresan Vadali
Internist - Cardiovascular Disease
4950 W 95th St
Oak Lawn
, Illinois 60453-2504
Dr. Maitrayee Sundaresan Vadali
Internist - Cardiovascular Disease
4950 W 95th St
Oak Lawn
, Illinois 60453-2504
(708) 576-8831
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About
Features
Specialties
- Internist - Cardiovascular Disease
Languages spoken
- English
Location
First Address
- Dr. Maitrayee Sundaresan Vadali
- 4950 W 95th St
- Oak Lawn, IL
- Zip : 60453-2504
- Fax : (708) 576-8831
- Phone : (708) 576-8150
Second Address
- Dr. Maitrayee Sundaresan Vadali
- 4950 W 95th St
- Oak Lawn, IL
- Zip : 60453-2504
- Fax : (708) 576-8831
- Phone : (708) 576-8150
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 207RC0000X | Internist - Cardiovascular Disease | 036-102767 | IL |
National Provider Identifier
| NPI | 1013900851 |
|---|---|
| Provider Name | Dr. Maitrayee Sundaresan Vadali |
| First Address | Oak Lawn, IL 60453-2504 |
| Second Address | Oak Lawn, IL 60453-2504 |
| Gender | F |
| NPI Entity type | Individual |
| Is Sole Proprietor | No |
| Is Organization Subpart | N/A |
| Enumeration Date | 26/08/2005 |
| Last Update Date | 31/12/2021 |
Additional Identifiers
| IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
|---|---|---|
| 036102767 | (05) | IL |
| 21622931 | BCBS GROUP # (01) | ID |
| CI8250 | PALMETTO GBA GROUP # (01) | IL |
| I04271 | (02) | IL |
| P00157926 | PALMETTO GBA INDIVIDUAL # (01) | IL |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.