Individual
ANTHONY VACCARO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
3245 N HALSTED ST, CHICAGO, IL 60657-3419
(312) 926-3627
Mailing address
3245 N HALSTED ST, CHICAGO, IL 60657-3419
(312) 926-3627
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
036-083332
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036-083332
—
IL
Enumeration date
07/17/2006
Last updated
06/30/2010
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