Look up the most recent NPI and PECOS records

Kaizan Kalyaniwalla

Radiology

Allopathic & Osteopathic Physicians

PECOS Enrollment

Based on the most recent information from CMS, provider Kaizan Kalyaniwalla is legally eligible to order and refer claims for Part B, HHA, DME and PMD services.

Part B
Medicare Part B
Enrolled
HHA
Home Health Agency
Enrolled
DME
Durable Medical Equipment
Enrolled
PMD
Power Mobility Device
Enrolled

CMS last updated its PECOS records 7 days ago.

Profile Details

Provider ID
1932465044
Provider Type
Individual
Full Name
Kalyaniwalla, Kaizan
Credential
DO

Gender
Male
Sole Proprietor
Yes
Enumeration Date
4/3/2012
Last Updated
1/3/2025

Contact Information

Practice Location

2160 S 1st Ave, Maywood, IL 60153-3328

(708) 216-9000

Unlisted Fax

Mailing Location

2160 S 1st Ave, Maywood, IL 60153-3328

(708) 216-9000

Unlisted Fax

Provider Taxonomies

Code	Description	License
Code 2085R0202X Primary	Description Radiology Allopathic & Osteopathic Physicians	License 036150526 Illinois

Kaizan Kalyaniwalla

PECOS Enrollment

Profile Details

Contact Information

Practice Location

Mailing Location

Provider Taxonomies

Code

Description

License

Code

Description

License

Edwards, Teresa Michelle

Gjeluci, Albert

Benjamin, Stefanie Duda

Mian, Farukh Saeed

Lowery, Emily Diane

Shah, Love

Yacoub, Joseph

Olson, Mary

Thapa, Nihal

Freiburg, Luke M