Gary John Vicik is a Specialist in Belleville, Illinois. Gary John Vicik practices all healthcare services and medical treatments related to Specialist. The NPI Number for Gary John Vicik is 1295708212. The last update date is 2012-05-21.
Gary John Vicik's current location address is 3608 W Main St, Belleville, Illinois. You can contact this provider via phone number 6183976605 and fax number 6182771251. The mailing address for Gary John Vicik is 3608 W Main St, Belleville, Illinois. To know further, please read the information below!
Provider Profile Detail
| Provider Name | Gary John Vicik |
|---|---|
| Address | 3608 W Main St, Belleville, Illinois |
| Phone Number | 6183976605 |
| Fax Number | 6182771251 |
| Sole Proprietor | N |
| Credentials | M.D. |
NPI Number Detail
| NPI Number | 1295708212 |
|---|---|
| Provider Enumeration Date | 2006-02-09 |
| Last Updated Date | 2012-05-21 |
Provider Mailing Address Detail
| Address | 3608 W Main St |
|---|---|
| City | Belleville |
| State | Illinois (IL) |
| Post Code | 622266225 |
| Phone Number | 6183976605 |
| Fax Number | 6182771251 |
Provider's Primary Taxonomy Detail
| Speciality | Specialist |
|---|---|
| Taxonomy | 174400000X |
| Licence No | 36-49185 |
|
Definition: An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. |
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Provider's Other Legacy Identifiers
| Identifier | Identifier Type | Identifier State | Identifier Issuer |
|---|---|---|---|
| 778106 | AETNA | ||
| 42561V34432 | GROUP HEALTH PLAN | ||
| 8215117 | IL | BLUE SHIELD | |
| 36049185 | IL | -- | |
| 42561V34432 | ADVANTRA | ||
| STL0307017 | UNITED HEALTHCARE | ||
| 101263 | HEALTHLINK | ||
| 202982 | GREAT WEST | ||
| 11512 | ESSENCE |
Post Comment/ Review Below
What is the unique 10-digit identification code assigned to Gary John Vicik by the Centers for Medicare & Medicaid Services?
The Gary John Vicik has been issued the NPI (National Provider Identifier) 1295708212, which serves as a unique identifier for healthcare providers, assigned by the Centers for Medicare & Medicaid Services (CMS).
Could you provide the complete address where Gary John Vicik is physically located?
The Gary John Vicik is situated at the following address: 3608 W Main St, Belleville, IL 622266225.
What is the Gary John Vicik's area of specialization and corresponding taxonomy classification?
The Gary John Vicik's specialty field is Specialist, and it falls under the taxonomy code 174400000X, which categorizes healthcare providers based on their specialties.
On what date did the Gary John Vicik receive the assignment of its 1295708212 from the Centers for Medicare & Medicaid Services?
The Gary John Vicik was issued its 1295708212 by the Centers for Medicare & Medicaid Services on 2006-02-09.
As of what date were the details related to Gary John Vicik most recently updated or revised?
The information pertaining to Gary John Vicik, including its address, specialty, and other relevant details, was last updated or revised on 2012-05-21.
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