Individual
DR. TERRANCE A. VAISVILAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
4440 W 95TH ST, OAK LAWN, IL 60453-2600
(708) 684-8000
Mailing address
185 PENNY AVE, EAST DUNDEE, IL 60118-1454
(847) 836-7015
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
036088183
IL
208VP0014X
Interventional Pain Medicine Physician
036088183
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036088183
—
IL
Enumeration date
06/19/2006
Last updated
03/31/2014
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