Organization
RIJ L VIRASCH MD
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TAMMY SANCHEZ (BILLING MANAGER)
(630) 424-1122
Entity
Organization
Contact information
Practice address
2800 N SHERIDAN RD., CHICAGO, IL 60657
(773) 935-5500
Mailing address
9349 NEENAH AVENUE, MORTON GROVE, IL 60053
(630) 424-1122
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
—
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
01608223
BCBS OF IL PROVIDER NO.
IL
Enumeration date
05/03/2007
Last updated
08/22/2020
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