Organization
VIJAY M. HARYANI, MD, SC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. VIJAY M HARYANI MD (PHYSICIAN OWNER)
(815) 936-3240
Entity
Organization
Contact information
Practice address
375 N WALL ST, SUITE 310, KANKAKEE, IL 60901-3483
(815) 936-3240
(815) 936-3243
Mailing address
375 N WALL ST, SUITE 310, KANKAKEE, IL 60901-3483
(815) 936-3240
(815) 936-3243
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
036072339
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
4632011
BCBS GROUP
IL
Enumeration date
10/19/2006
Last updated
10/21/2009
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