Basic Information
| Provider Information | |||||||||
| NPI: | 1780970731 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | BAXI | ||||||||
| FirstName: | PRAVIR | ||||||||
| MiddleName: | |||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1426 W WASHINGTON BLVD | ||||||||
| Address2: | |||||||||
| City: | CHICAGO | ||||||||
| State: | IL | ||||||||
| PostalCode: | 606071821 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7349040929 | ||||||||
| FaxNumber: | 3128508431 | ||||||||
| Practice Location | |||||||||
| Address1: | 1426 W WASHINGTON BLVD | ||||||||
| Address2: | |||||||||
| City: | CHICAGO | ||||||||
| State: | IL | ||||||||
| PostalCode: | 606071821 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3128508434 | ||||||||
| FaxNumber: | 3128508431 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/28/2011 | ||||||||
| LastUpdateDate: | 06/01/2022 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 06/01/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207RN0300X | 036135424 | IL | Y | Allopathic & Osteopathic Physicians | Internal Medicine | Nephrology |
No ID Information.