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Individual

DR. ROSHNI A. VASAIWALA

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
M.D.

Contact information

Practice address
DEPT. 4684, CAROL STREAM, IL 60122-4684
(708) 952-0109
(708) 952-0329
Mailing address
4684 DEPT, SUITE 1, CAROL STREAM, IL 60122-4684
(708) 952-0109
(708) 952-0329

Taxonomy

Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
036128553
IL
207WX0120X
Cornea and External Diseases Specialist Physician
Primary
036128553
IL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
01620861
BLUE CROSS BLUE SHEILD GRP ID NUMBER
IL
01
036128553
PHYSICIAN LICENSE
IL
05
036128553
IL
01
1083684922
GROUP NPI
IL
01
12324832
CAQH
IL
01
1699802421
OPTICAL NPI THE EYE SPECIALISTS CENTER
IL
01
205785
PTAN IL MEDICARE COOK COUNTY
IL
01
205786
PTAN IL MEDICARE DUPAGE COUNTY
IL
01
60180260001
DEMERC SUPPLIER PTAN
IL
01
CK7818
MEDICARE RAILROAD GRP PTAN
IL
Enumeration date
04/16/2008
Last updated
10/06/2021
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