Provider Demographics
NPI:1285622878
Name:AREKAPUDI, VIJAYALAKSHMI (MD)
Entity type:Individual
Prefix:
First Name:VIJAYALAKSHMI
Middle Name:
Last Name:AREKAPUDI
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2734 N LINCOLN AVE
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60614-1321
Mailing Address - Country:US
Mailing Address - Phone:773-525-7720
Mailing Address - Fax:773-525-9199
Practice Address - Street 1:2222 W DIVISION ST STE 116
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60622-3093
Practice Address - Country:US
Practice Address - Phone:773-525-7720
Practice Address - Fax:773-525-9199
Is Sole Proprietor?:No
Enumeration Date:2005-10-08
Last Update Date:2008-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036058407207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL036058407Medicaid
ILD13906Medicare UPIN