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Organization
VINOD MOTIANI MD SC
Active
Organization
VINOD MOTIANI MD SC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JOHN MILLER (ACCOUNT EXECUTIVE)
(815) 834-7232
Entity
Organization
Contact information
Practice address
404 W BOUGHTON RD, SUITE A, BOLINGBROOK, IL 60440-1898
(815) 834-7232
(815) 834-1307
Mailing address
404 W BOUGHTON RD, SUITE A, BOLINGBROOK, IL 60440-1898
(815) 834-7232
(815) 834-1307
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
036-072068
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036072068
—
IL
01
—
110170972
MEDICARE RR
IL
01
—
1508032053
TYPE 2 NPI
IL
01
—
2201614
BCBS
—
Enumeration date
05/05/2008
Last updated
06/09/2010
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