Provider Demographics
NPI:1215022074
Name:CUK, VANJA (MD)
Entity Type:Individual
Prefix:
First Name:VANJA
Middle Name:
Last Name:CUK
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:303 E ARMY TRAIL RD
Mailing Address - Street 2:SUITE 100
Mailing Address - City:BLOOMINGDALE
Mailing Address - State:IL
Mailing Address - Zip Code:60108
Mailing Address - Country:US
Mailing Address - Phone:630-980-8600
Mailing Address - Fax:630-980-8650
Practice Address - Street 1:303 E ARMY TRAIL RD
Practice Address - Street 2:SUITE 100
Practice Address - City:BLOOMINGDALE
Practice Address - State:IL
Practice Address - Zip Code:60108
Practice Address - Country:US
Practice Address - Phone:630-980-8600
Practice Address - Fax:630-980-8650
Is Sole Proprietor?:No
Enumeration Date:2006-10-04
Last Update Date:2021-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036100024207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL036100024Medicaid
H01036Medicare UPIN
IL036100024Medicaid
IL75076003Medicare PIN