Organization
WESTLAKE HOSPITAL
Active
Other names
Westlake Medical Associates
Organization subpart
No
Provider details
NPI number
Authorized official
DR. VIJAY V YELDANDI M.D. (MEDICAL DIRECTOR)
(708) 938-7350
Entity
Organization
Contact information
Practice address
1111 SUPERIOR ST STE 101, MELROSE PARK, IL 60160-4100
(708) 344-2161
(708) 344-3156
Mailing address
1111 SUPERIOR ST STE 101, MELROSE PARK, IL 60160-4100
(708) 344-2161
(708) 344-3156
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036069861
—
IL
01
—
1623610
BLUE CROSS BLUE SHIELD
—
Enumeration date
03/21/2007
Last updated
02/27/2009
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