Provider Demographics
NPI:1366474686
Name:SATISH K VIJ MD SCC
Entity Type:Organization
Organization Name:SATISH K VIJ MD SCC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:SATISH
Authorized Official - Middle Name:K
Authorized Official - Last Name:VIJ
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:847-328-5550
Mailing Address - Street 1:800 AUSTIN STREET
Mailing Address - Street 2:SUITE 269 EAST TOWER
Mailing Address - City:EVANSTON
Mailing Address - State:IL
Mailing Address - Zip Code:60202
Mailing Address - Country:US
Mailing Address - Phone:847-328-5550
Mailing Address - Fax:847-328-5606
Practice Address - Street 1:800 AUSTIN STREET
Practice Address - Street 2:SUITE 269 EAST TOWER
Practice Address - City:EVANSTON
Practice Address - State:IL
Practice Address - Zip Code:60202
Practice Address - Country:US
Practice Address - Phone:847-328-5550
Practice Address - Fax:847-328-5606
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-07
Last Update Date:2012-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036049125207RE0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RE0101XAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & MetabolismGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL702490Medicare ID - Type Unspecified