Individual
VIJAY P ROY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1340 CHARLES ST STE 300, ROCKFORD, IL 61104-2200
(779) 696-5888
Mailing address
PO BOX 78866, MILWAUKEE, WI 53278-8866
(779) 696-7150
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
036-089410
IL
207RC0000X
Cardiovascular Disease Physician
Primary
036089410
IL
207UN0901X
Nuclear Cardiology Physician
036089410
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036089410
—
IL
Enumeration date
10/19/2006
Last updated
08/20/2025
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