Provider Demographics
NPI:1194204461
Name:VIP 2U, INC
Entity Type:Organization
Organization Name:VIP 2U, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:ANTHONY
Authorized Official - Middle Name:
Authorized Official - Last Name:SICILIANO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:630-715-9738
Mailing Address - Street 1:477 E BUTTERFIELD RD STE 400
Mailing Address - Street 2:
Mailing Address - City:LOMBARD
Mailing Address - State:IL
Mailing Address - Zip Code:60148-4881
Mailing Address - Country:US
Mailing Address - Phone:630-368-1102
Mailing Address - Fax:630-368-1104
Practice Address - Street 1:477 E BUTTERFIELD RD STE 400
Practice Address - Street 2:
Practice Address - City:LOMBARD
Practice Address - State:IL
Practice Address - Zip Code:60148
Practice Address - Country:US
Practice Address - Phone:630-368-1102
Practice Address - Fax:630-368-1104
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-08-08
Last Update Date:2018-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty