Provider Demographics
NPI:1780677740
Name:VILCHECK, JOHN F JR (OD)
Entity Type:Individual
Prefix:DR
First Name:JOHN
Middle Name:F
Last Name:VILCHECK
Suffix:JR
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:644 E REECEVILLE RD
Mailing Address - Street 2:
Mailing Address - City:COATESVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:19320-1232
Mailing Address - Country:US
Mailing Address - Phone:610-383-6449
Mailing Address - Fax:610-383-1227
Practice Address - Street 1:644 E REECEVILLE RD
Practice Address - Street 2:
Practice Address - City:COATESVILLE
Practice Address - State:PA
Practice Address - Zip Code:19320-1232
Practice Address - Country:US
Practice Address - Phone:610-383-6449
Practice Address - Fax:610-383-1227
Is Sole Proprietor?:Yes
Enumeration Date:2005-08-25
Last Update Date:2010-05-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOEG000965152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA002948OtherAETNA
PA410024646OtherRAILROAD MEDICARE PROVIDE
PA0164990001OtherNATIONAL SUPPLIER CLEARIN
PARR1201OtherRAILROAD MED SUBMITT NO.
PA80240Medicare ID - Type UnspecifiedMEDICARE ID NUMBER
PA002948OtherAETNA