Provider Demographics
NPI:1649238221
Name:ADMA, VISHAL K (MD)
Entity type:Individual
Prefix:
First Name:VISHAL
Middle Name:K
Last Name:ADMA
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:PO BOX 74008272
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60674-8272
Mailing Address - Country:US
Mailing Address - Phone:702-899-0595
Mailing Address - Fax:702-977-1496
Practice Address - Street 1:12340 QUIVIRA RD
Practice Address - Street 2:
Practice Address - City:OVERLAND PARK
Practice Address - State:KS
Practice Address - Zip Code:66213-2408
Practice Address - Country:US
Practice Address - Phone:872-231-3162
Practice Address - Fax:702-977-1496
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-03
Last Update Date:2025-12-19
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
KS04282482084P0800X
MO20001608662084P0800X
IL0361543052084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO205151202Medicaid
KS30004247320013Medicaid