Provider Demographics
NPI:1629356241
Name:KAPIL VIJ DDS MS PC
Entity Type:Organization
Organization Name:KAPIL VIJ DDS MS PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:
Authorized Official - First Name:KAPIL
Authorized Official - Middle Name:
Authorized Official - Last Name:VIJ
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:847-372-4030
Mailing Address - Street 1:259 E RAND RD STE 110
Mailing Address - Street 2:
Mailing Address - City:MOUNT PROSPECT
Mailing Address - State:IL
Mailing Address - Zip Code:60056-2184
Mailing Address - Country:US
Mailing Address - Phone:847-321-9445
Mailing Address - Fax:
Practice Address - Street 1:259 E RAND RD STE 110
Practice Address - Street 2:
Practice Address - City:MOUNT PROSPECT
Practice Address - State:IL
Practice Address - Zip Code:60056-2184
Practice Address - Country:US
Practice Address - Phone:847-321-9445
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-07-31
Last Update Date:2011-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL019-025148261QD0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental