Provider Demographics
NPI:1275688434
Name:VINCENT A. SACKETT, M.D., LTD.
Entity Type:Organization
Organization Name:VINCENT A. SACKETT, M.D., LTD.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:VINCENT
Authorized Official - Middle Name:ANTHONY
Authorized Official - Last Name:SACKETT
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:630-323-2229
Mailing Address - Street 1:201 E OGDEN AVE
Mailing Address - Street 2:SUITE 214
Mailing Address - City:HINSDALE
Mailing Address - State:IL
Mailing Address - Zip Code:60521-3633
Mailing Address - Country:US
Mailing Address - Phone:630-323-2229
Mailing Address - Fax:630-323-5011
Practice Address - Street 1:201 E OGDEN AVE
Practice Address - Street 2:SUITE 214
Practice Address - City:HINSDALE
Practice Address - State:IL
Practice Address - Zip Code:60521-3633
Practice Address - Country:US
Practice Address - Phone:630-323-2229
Practice Address - Fax:630-323-5011
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-25
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL2084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Single Specialty