Organization
DAVID VIGDER MD SC
Active
Organization
DAVID VIGDER MD SC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DAVID M VIDGER M.D. (PRESIDENT)
(847) 615-2227
Entity
Organization
Contact information
Practice address
800 N WESTMORELAND RD, SUITE 206, LAKE FOREST, IL 60045-1673
(847) 615-2227
(847) 615-2228
Mailing address
800 N WESTMORELAND RD, SUITE 206, LAKE FOREST, IL 60045-1673
(847) 615-2227
(847) 615-2228
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
036094188
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036094188
—
IL
01
—
4922698
BLUE CROSS BLUE SHIELD
IL
Enumeration date
07/27/2006
Last updated
07/10/2023
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