1184705501 NPI number — BABAK VAKILI MD

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1184705501 NPI number — BABAK VAKILI MD

Employer Identification Number (EIN):

Provider Organization Name:

Provider Last Name:

VAKILI

Provider First Name:

BABAK

Provider Middle Name:

Provider Name Prefix Text:

Provider Name Suffix Text:

Provider Credential Text:

MD

Provider Gender Code:

M

Provider Other Organization Name:

Provider Other Organization Name Type Code:

Provider Other Last Name:

Provider Other First Name:

Provider Other Middle Name:

Provider Other Name Prefix Text:

Provider Other Name Suffix Text:

Provider Other Credential Text:

Provider Other Last Name Type Code:

NPI Number:

1184705501

Entity Type Code:

Individual

Replacement NPI:

Last Update Date:

04/08/2025

NPI Deactivation Reason Code:

NPI Deactivation Date:

NPI Reactivation Date:

Provider First Line Business Mailing Address:

7974 UW HEALTH CT

Provider Second Line Business Mailing Address:

Provider Business Mailing Address City Name:

MIDDLETON

Provider Business Mailing Address State Name:

WI

Provider Business Mailing Address Postal Code:

53562-5531

Provider Business Mailing Address Country Code:

US

Provider Business Mailing Address Telephone Number:

Provider Business Mailing Address Fax Number:

Provider First Line Business Practice Location Address:

4621 EASTPARK BLVD

Provider Second Line Business Practice Location Address:

Provider Business Practice Location Address City Name:

MADISON

Provider Business Practice Location Address State Name:

WI

Provider Business Practice Location Address Postal Code:

53718-2000

Provider Business Practice Location Address Country Code:

US

Provider Business Practice Location Address Telephone Number:

608-914-0800

Provider Business Practice Location Address Fax Number:

Provider Enumeration Date:

10/19/2006

Authorized Official Last Name:

Authorized Official First Name:

Authorized Official Middle Name:

Authorized Official Title or Position:

Authorized Official Telephone Number:

• Taxonomy code: 207V00000X , with the licence number:  C1-0007396 , registered in the state of DE ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
• Taxonomy code: 207VF0040X , with the licence number: C1-0007396 , registered in the state of DE ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
• Taxonomy code: 207V00000X , with the licence number: MA077964 , registered in the state of NJ ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
• Taxonomy code: 207VF0040X , with the licence number: 25MA07796400 , registered in the state of NJ ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
• Taxonomy code: 207V00000X , with the licence number: 102645 , registered in the state of WI ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
• Taxonomy code: 2086S0122X , with the licence number: MA077964 , registered in the state of NJ ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
• Taxonomy code: 2088F0040X , with the licence number: C1-0007396 , registered in the state of DE ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
• Taxonomy code: 2088F0040X , with the licence number: 25MA07796400 , registered in the state of NJ ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
• Taxonomy code: 207VF0040X , with the licence number: 102645 , registered in the state of WI ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

• Identifier: 60032176 . This is a "HORIZON NJ HEALTH" identifier , issued by the state of ( NJ ) . This identifiers is of the category "OTHER".
• Identifier: 0047147 , issued by the state of ( NJ ) . This identifiers is of the category "MEDICAID".
• Identifier: 3687734 . This is a "AETNA" identifier , issued by the state of ( NJ ) . This identifiers is of the category "OTHER".
• Identifier: 3K6122 . This is a "HEALTHNET" identifier , issued by the state of ( NJ ) . This identifiers is of the category "OTHER".
• Identifier: 223235UGN . This is a "HORIZON BC BS OF DE" identifier , issued by the state of ( DE ) . This identifiers is of the category "OTHER".
• Identifier: 8988499 . This is a "CIGNA" identifier , issued by the state of ( NJ ) . This identifiers is of the category "OTHER".
• Identifier: P3500220 . This is a "OXFORD" identifier , issued by the state of ( NJ ) . This identifiers is of the category "OTHER".
• Identifier: 1000036281 , issued by the state of ( DE ) . This identifiers is of the category "MEDICAID".
• Identifier: 1727563 . This is a "AMERIHEALTH/DELAWARE" identifier , issued by the state of ( DE ) . This identifiers is of the category "OTHER".
• Identifier: 306494 . This is a "COVENTRY" identifier , issued by the state of ( DE ) . This identifiers is of the category "OTHER".
• Identifier: 60022398 . This is a "HORIZON NJ HEALTH" identifier , issued by the state of ( NJ ) . This identifiers is of the category "OTHER".
• Identifier: 1000035674 . This is a "DELAWARE PHYSICIANS" identifier , issued by the state of ( DE ) . This identifiers is of the category "OTHER".
• Identifier: 2395668000 . This is a "AMERIHEALTH/KEYSTONE/IBC" identifier , issued by the state of ( NJ ) . This identifiers is of the category "OTHER".
• Identifier: 26634 . This is a "CHRISTIANA HEALTH CARE" identifier , issued by the state of ( DE ) . This identifiers is of the category "OTHER".
• Identifier: 2503150 . This is a "UNITED HEALTH CARE" identifier , issued by the state of ( NJ ) . This identifiers is of the category "OTHER".
• Identifier: 42302 . This is a "UNIVERISRY HEALTH PLAN" identifier , issued by the state of ( NJ ) . This identifiers is of the category "OTHER".