| Doctor Name: | BHAVANA VAIDYA |
| NPI Number: | 1437141108 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | MD |
| License Number: | 036066303 |
| Business Practice Address: | 326 W 64th St Chicago, IL - 606213114 |
| Business Phone Number: | 7739623900 |
| Business Fax Number: | |
| Mailing Address: | 10601 S Kilbourn Ave, OAK LAWN |
| State: | IL |
| Postal Code: | 604535341 |
| Phone Number: | 7734252516 |
| Fax Number: | |
| NPI Enumeration Date: | 08/18/2005 |
| NPI Last Update Date: | 02/19/2014 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 208D00000X |
| License Number: | 036066303 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | IL |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | General Practice |
| Taxonomy Specialization: | |
| Taxonomy Definition: | |