Individual
NEHA PANKAJ VAGADIA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
240 E HURON ST, CHICAGO, IL 60611-2909
(312) 503-1851
Mailing address
240 E HURON ST STE 1-200, CHICAGO, IL 60611-2909
(312) 503-1851
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
—
—
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
02/10/2020
Last updated
09/10/2021
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