Provider Demographics
NPI:1235275058
Name:DAVID F. VIK, M.D.,S.C.
Entity Type:Organization
Organization Name:DAVID F. VIK, M.D.,S.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:FRANCIS
Authorized Official - Last Name:VIK
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:630-476-4771
Mailing Address - Street 1:12958 BRADFORD LN
Mailing Address - Street 2:
Mailing Address - City:PLAINFIELD
Mailing Address - State:IL
Mailing Address - Zip Code:60585-2106
Mailing Address - Country:US
Mailing Address - Phone:630-476-1771
Mailing Address - Fax:
Practice Address - Street 1:12958 BRADFORD LN
Practice Address - Street 2:
Practice Address - City:PLAINFIELD
Practice Address - State:IL
Practice Address - Zip Code:60585-2106
Practice Address - Country:US
Practice Address - Phone:630-476-1771
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-29
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL567030Medicare ID - Type Unspecified
ILH08943Medicare UPIN