Individual
DR. JEFF T VICTOR
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
2455 DEAN ST STE A&B, ST CHARLES, IL 60175-4830
(630) 208-7388
(630) 208-4818
Mailing address
PO BOX 7630, GURNEE, IL 60031-7002
(630) 208-7388
(630) 208-4818
Taxonomy
Speciality
Code
Description
License number
State
207RG0100X
Gastroenterology Physician
Primary
036102795
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
203529
MEDICARE GROUP
IL
05
—
36102795
—
IL
Enumeration date
07/07/2005
Last updated
05/07/2021
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