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VASCULAR SPECIALISTS LLC NPI 1992126668


NPI Information

NPI: 1992126668
Provider Name: VASCULAR SPECIALISTS LLC
Classification: Surgery - 2086S0129X
Entity Type: Organization

Specialization: Vascular Surgery

CLIA Number: 14D2107989

Address:
20060 GOVERNORS DR STE 102
OLYMPIA FIELDS, IL
ZIP 60461
Phone: (708) 305-2620
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VASCULAR SPECIALISTS LLC is a vascular surgery surgery in Olympia Fields, IL. The provider is a surgeon with expertise in the management of surgical disorders of the blood vessels, excluding the intracranial vessels or the heart. VASCULAR SPECIALISTS LLC NPI is 1992126668. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

20060 GOVERNORS DR STE 102
OLYMPIA FIELDS, IL
ZIP 60461-099
Phone: (708) 305-2620
Fax: (708) 856-0567

The provider's authorized official is Eugene M Tanquilut .
The authorized official title is Owner and has the following contact phone number (708) 305-0248.

The CLIA number assigned to this NPI record is 14D2107989 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 12/26/2013 and was last updated on 5/8/2018.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
12086S0129XSurgeryVascular SurgeryYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

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