Individual
DR. PRABHA VAIDYA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
1545 WAUKEGAN RD, GLENVIEW, IL 60025-2166
(847) 729-8986
Mailing address
1545 WAUKEGAN RD, GLENVIEW, IL 60025-2166
(847) 729-8986
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
—
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
01636495
BC/BS
IL
Enumeration date
10/13/2006
Last updated
07/08/2007
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