Individual
VIDHAN SRIVASTAVA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
5841 S MARYLAND AVE, CHICAGO, IL 60637-1443
(773) 702-6842
Mailing address
180 HARVESTER DR STE 110, BURR RIDGE, IL 60527-6686
(773) 702-1150
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
1025343
MA
207L00000X
Anesthesiology Physician
Primary
125.074391
IL
Other
Enumeration date
03/28/2019
Last updated
12/30/2025
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