Individual
DR. VIVIAN GAHTAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
2160 S 1ST AVE, MAYWOOD, IL 60153-3328
(708) 216-9000
Mailing address
2160 S 1ST AVE, MAYWOOD, IL 60153-3328
(708) 216-9000
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
036150851
IL
208600000X
Surgery Physician
230018
NY
2086S0129X
Vascular Surgery Physician
Primary
036150851
IL
2086S0129X
Vascular Surgery Physician
230018
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01924487
—
NY
01
—
P00066704
RAILROAD MEDICARE
NY
Enumeration date
05/22/2006
Last updated
08/13/2025
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