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Individual
VIVIAN S VANROEKEL
Active
Individual
VIVIAN S VANROEKEL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
036064522
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036064522
—
IL
01
—
920540
MEDICARE PTAN (GROUP)
IL
01
—
920540026
MEDICARE PTAN (INDIVIDUAL)
IL
01
—
DB1658
MEDICARE RAILROAD (GROUP)
IL
01
—
P01273137
MEDICARE RAILROAD (INDIVIDUAL)
IL
Enumeration date
05/23/2005
Last updated
04/07/2014
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