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Organization
VYAS HARSHAVADAN J MD
Active
Organization
VYAS HARSHAVADAN J MD
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. HARSHAVADAN J VYAS M.D.. (PHYSICIAN/OWNER)
(815) 433-3331
Entity
Organization
Contact information
Practice address
1013 CLINTON ST, OTTAWA, IL 61350-2039
(815) 433-3331
(815) 433-3344
Mailing address
1013 CLINTON ST, OTTAWA, IL 61350-2039
(815) 433-3331
(815) 433-3344
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
036071120
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036071120
—
IL
01
—
500034350
BLUECROSS BLUE SHIELD PROVIDER ID
IL
Enumeration date
02/21/2012
Last updated
02/21/2012
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