Individual
MR. JUAN L VEGA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
W3985 COUNTY ROAD NN, ELKHORN, WI 53121-4337
(262) 741-2000
(262) 741-2180
Mailing address
PO BOX 735044, CHICAGO, IL 60673-5044
(262) 741-2000
(262) 741-2180
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
57028
WI
207LC0200X
Critical Care Medicine (Anesthesiology) Physician
57028
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100034034
—
WI
05
—
1396061859
—
WI
Enumeration date
04/08/2010
Last updated
10/03/2023
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