Provider Demographics
NPI:1821760752
Name:IL VEIN SPECIALISTS, LTD.
Entity Type:Organization
Organization Name:IL VEIN SPECIALISTS, LTD.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRACTICE ADMINISTRATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:KELLY
Authorized Official - Middle Name:LEE
Authorized Official - Last Name:BANKS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:847-277-9100
Mailing Address - Street 1:22285 N PEPPER RD STE 105
Mailing Address - Street 2:
Mailing Address - City:LAKE BARRINGTON
Mailing Address - State:IL
Mailing Address - Zip Code:60010-2539
Mailing Address - Country:US
Mailing Address - Phone:847-277-9100
Mailing Address - Fax:847-277-9110
Practice Address - Street 1:22285 N PEPPER RD STE 105
Practice Address - Street 2:
Practice Address - City:LAKE BARRINGTON
Practice Address - State:IL
Practice Address - Zip Code:60010-2539
Practice Address - Country:US
Practice Address - Phone:847-277-9100
Practice Address - Fax:847-277-9110
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-09-29
Last Update Date:2021-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM2500XAmbulatory Health Care FacilitiesClinic/CenterMedical Specialty