Individual
MR. DANIEL P VICENCIO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
2525 S MICHIGAN AVE, B-390, CHICAGO, IL 60616-2333
(312) 567-6691
(312) 328-7702
Mailing address
2525 S MICHIGAN AVE, B-390, CHICAGO, IL 60616-2333
(312) 567-6691
(312) 328-7702
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
036088743
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
01621679
BCBS OF IL
IL
05
—
036088743
—
IL
Enumeration date
12/13/2005
Last updated
05/06/2021
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Contact us