Provider Demographics
NPI:1437316452
Name:KUMAR, VINOD
Entity Type:Individual
Prefix:
First Name:VINOD
Middle Name:
Last Name:KUMAR
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1198
Mailing Address - Street 2:
Mailing Address - City:PLAINFIELD
Mailing Address - State:IL
Mailing Address - Zip Code:60544-1198
Mailing Address - Country:US
Mailing Address - Phone:630-728-9827
Mailing Address - Fax:
Practice Address - Street 1:1444 N FARNSWORTH AVE
Practice Address - Street 2:SUITE # 400
Practice Address - City:AURORA
Practice Address - State:IL
Practice Address - Zip Code:60505-1640
Practice Address - Country:US
Practice Address - Phone:630-428-5850
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-05-19
Last Update Date:2009-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL070-009595225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist