Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RC0000X | Internist - Cardiovascular Disease | 036115836 | IL |
N | 207RC0001X | Clinical Cardiac Electrophysiologist | 036115836 | IL |
NPI | 1134381205 |
---|---|
Provider Name | Dr. Smit C Vasaiwala |
First Address | Chicago, IL 60610-2171 |
Second Address | Maywood, IL 60153-3328 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 30/06/2008 |
Last Update Date | 19/10/2018 |