Provider Demographics
NPI:1427068352
Name:BADLANI, VANDANA K (MD)
Entity type:Individual
Prefix:
First Name:VANDANA
Middle Name:K
Last Name:BADLANI
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 1:952 E 54TH PL
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60615-5061
Mailing Address - Country:US
Mailing Address - Phone:773-883-3953
Mailing Address - Fax:773-883-3649
Practice Address - Street 1:2266 N LINCOLN AVE LOWR LEVEL
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60614-7600
Practice Address - Country:US
Practice Address - Phone:773-883-3953
Practice Address - Fax:773-883-3649
Is Sole Proprietor?:No
Enumeration Date:2006-08-09
Last Update Date:2019-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036106577207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
K25470Medicare UPIN
H77524Medicare UPIN