Mazumdar, Avi
Mazumdar, Avi is an individual health care provider with primary practice located at 25 N Winfield Rd Suite 500, Winfield IL 60190-1295. He recently has 4 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Neurology, Allopathic & Osteopathic Physicians / Neuroradiology, Allopathic & Osteopathic Physicians / Diagnostic Radiology, Allopathic & Osteopathic Physicians / Vascular & Interventional Radiology. Allopathic & Osteopathic Physicians / Vascular & Interventional Radiology is his primary health care specialty. Mazumdar, Avi can be contacted via phone (630) 933-2113.Contact Information
Primary practice address
25 N Winfield Rd Suite 500
Winfield IL 60190-1295
Phone: (630) 933-2113
Fax: (630) 933-4520
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Neurology | 2084N0400X | 2002021169 | Missouri |
| Allopathic & Osteopathic Physicians / Neuroradiology | 2085N0700X | 036113885 | Illinois |
| Allopathic & Osteopathic Physicians / Diagnostic Radiology | 2085R0202X | 036113885 | Illinois |
| Allopathic & Osteopathic Physicians / Vascular & Interventional Radiology | 2085R0204X | 036113885 | Illinois |
Profile Details
| NPI number | 1760547889 |
|---|---|
| LBN Legal business name | Mazumdar, Avi |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Dec 27th, 2006 |
| Last updated | Jan 22nd, 2018 - about 7 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1760547889 | NPPES |
| Illinois | Other | P00762032 | RR MEDICARE (INDIVIDUAL) |
| Illinois | Other | 206147 | RR MEDICARE (INDIVIDUAL) |
| Illinois | MEDICAID | 207599606 | RR MEDICARE (INDIVIDUAL) |
| Illinois | MEDICAID | 036113885 | RR MEDICARE (INDIVIDUAL) |
| Illinois | Other | K35062 | RR MEDICARE (INDIVIDUAL) |
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