Individual
DR. AVI MAZUMDAR
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
25 N WINFIELD RD, SUITE 500, WINFIELD, IL 60190-1295
(630) 933-2113
(630) 933-4520
Mailing address
25 N WINFIELD RD, SUITE 500, WINFIELD, IL 60190-1295
(630) 933-2113
(630) 933-4520
Taxonomy
Speciality
Code
Description
License number
State
2084N0400X
Neurology Physician
2002021169
MO
2085N0700X
Neuroradiology Physician
036113885
IL
2085R0202X
Diagnostic Radiology Physician
036113885
IL
2085R0204X
Vascular & Interventional Radiology Physician
Primary
036113885
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036113885
—
IL
01
—
206147
MEDICARE PTAN (GROUP)
IL
05
—
207599606
—
MO
01
—
K35062
MEDICARE PTAN (INDIVIDUAL)
IL
01
—
P00762032
RR MEDICARE (INDIVIDUAL)
IL
Enumeration date
12/27/2006
Last updated
01/22/2018
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Contact us