Individual
AMIT VYAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2200 FORT JESSE ROAD, STE. 280, NORMAL, IL 61761-6289
(730) 945-2178
(309) 862-1302
Mailing address
2200 FORT JESSE ROAD, SUITE 280, NORMAL, IL 61761-6289
(309) 452-1788
(309) 862-1302
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
036.123244
IL
2085R0202X
Diagnostic Radiology Physician
4301081953
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036123244
—
IL
Enumeration date
05/11/2007
Last updated
02/26/2010
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