Organization
CENTER FOR NEUROLOGICAL DISEASES S.C
Active
Organization subpart
No
Provider details
NPI number
Authorized official
RAKESH VEDAVYAS MR (MANAGER)
(815) 741-9719
Entity
Organization
Contact information
Practice address
2222 WEBER RD, CREST HILL, IL 60403-0928
(815) 741-9719
(815) 744-5137
Mailing address
2222 WEBER RD, CREST HILL, IL 60403-0928
(815) 741-9719
(815) 744-5137
Taxonomy
Speciality
Code
Description
License number
State
207T00000X
Neurological Surgery Physician
036083980
IL
207T00000X
Neurological Surgery Physician
Primary
036097009
IL
207T00000X
Neurological Surgery Physician
036115848
IL
Other
Enumeration date
06/24/2006
Last updated
10/22/2012
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