Organization
VEIN AND VASCULAR CENTERS, SC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DIANE SARKA (CREDENTIALING CONSULTANT)
(630) 928-5234
Entity
Organization
Contact information
Practice address
7 N GRANT ST STE 1, HINSDALE, IL 60521-3366
(630) 320-6877
Mailing address
903 COMMERCE DR STE 333, OAK BROOK, IL 60523-8723
(630) 928-5234
Taxonomy
Speciality
Code
Description
License number
State
2085R0204X
Vascular & Interventional Radiology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
036096152
STATE LICENSE
IL
Enumeration date
12/07/2017
Last updated
12/20/2017
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