Individual
PAUL T VAITKUS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1340 CHARLES ST STE 300, ROCKFORD, IL 61104-2200
(815) 490-5889
Mailing address
PO BOX 1567, ROCKFORD, IL 61110-0067
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
—
IL
Other
Enumeration date
09/27/2006
Last updated
07/09/2007
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