Individual
DAVID VIGDER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
800 N WESTMORELAND RD, SUITE 206, LAKE FOREST, IL 60045-1673
(847) 615-2227
(847) 615-2228
Mailing address
800 N WESTMORELAND RD, SUITE 206, LAKE FOREST, IL 60045-1673
(847) 615-2227
(847) 615-2228
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
036094188
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
4922698
BLUE SHIELD BLUE CROSS
IL
Enumeration date
10/12/2006
Last updated
12/08/2020
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