Provider Demographics
NPI:1265673701
Name:JAYESINGHE, VIPULI E (MD)
Entity Type:Individual
Prefix:
First Name:VIPULI
Middle Name:E
Last Name:JAYESINGHE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:VIPULI
Other - Middle Name:
Other - Last Name:ABEYSEKERA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:16615 S RTE 59
Mailing Address - Street 2:
Mailing Address - City:PLAINFIELD
Mailing Address - State:IL
Mailing Address - Zip Code:60586-2941
Mailing Address - Country:US
Mailing Address - Phone:815-436-7303
Mailing Address - Fax:
Practice Address - Street 1:16615 S RTE 59
Practice Address - Street 2:
Practice Address - City:PLAINFIELD
Practice Address - State:IL
Practice Address - Zip Code:60586-2941
Practice Address - Country:US
Practice Address - Phone:815-436-7303
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-03-12
Last Update Date:2021-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036122094207Q00000X
IL036-122094207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine