Provider Demographics
NPI:1508104068
Name:GILVYDIS VEIN CLINIC, LTD.
Entity Type:Organization
Organization Name:GILVYDIS VEIN CLINIC, LTD.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:RIMVYDAS
Authorized Official - Middle Name:P
Authorized Official - Last Name:GILVYDIS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:630-571-6770
Mailing Address - Street 1:2127 MIDLANDS CT
Mailing Address - Street 2:#102
Mailing Address - City:SYCAMORE
Mailing Address - State:IL
Mailing Address - Zip Code:60178-3173
Mailing Address - Country:US
Mailing Address - Phone:815-981-4742
Mailing Address - Fax:
Practice Address - Street 1:2127 MIDLANDS CT
Practice Address - Street 2:#102
Practice Address - City:SYCAMORE
Practice Address - State:IL
Practice Address - Zip Code:60178-3173
Practice Address - Country:US
Practice Address - Phone:815-981-4742
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-01-17
Last Update Date:2016-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2085R0204XAllopathic & Osteopathic PhysiciansRadiologyVascular & Interventional RadiologyGroup - Multi-Specialty
No2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic RadiologyGroup - Multi-Specialty