# VEIN CARE INSTITUTE, LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Premier Vascular Laboratory
- **Organization subpart:** No

## Provider details

- **NPI number:** 1285812529
- **Authorized official:** EUGENE M TANQUILUT D.O. (MEMBER)
- **Authorized official phone:** (708) 305-0248

## Contact information

- **Practice address:** 3736 W 26TH ST, CHICAGO, IL 60623-3826
- **Practice address phone:** (773) 277-1100
- **Mailing address:** 16406 PEPPERWOOD TRL, ORLAND HILLS, IL 60487-5644
- **Mailing address phone:** (708) 305-2620

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261Q00000X | Clinic/Center | — | NULL | Yes |

## Other

- **Enumeration date:** 02/08/2008
- **Last updated:** 02/08/2008