Provider Demographics
NPI:1366612699
Name:VYAS, SHUCHI I (MD)
Entity type:Individual
Prefix:
First Name:SHUCHI
Middle Name:I
Last Name:VYAS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:767 PARK AVE W
Mailing Address - Street 2:STE 260
Mailing Address - City:HIGHLAND PARK
Mailing Address - State:IL
Mailing Address - Zip Code:60035-2400
Mailing Address - Country:US
Mailing Address - Phone:847-432-7222
Mailing Address - Fax:847-432-9360
Practice Address - Street 1:767 PARK AVE W
Practice Address - Street 2:STE 260
Practice Address - City:HIGHLAND PARK
Practice Address - State:IL
Practice Address - Zip Code:60035-2400
Practice Address - Country:US
Practice Address - Phone:847-432-7222
Practice Address - Fax:847-432-9360
Is Sole Proprietor?:No
Enumeration Date:2008-03-03
Last Update Date:2021-11-29
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
IL036114051207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology