Provider Demographics
NPI:1942232558
Name:ELOY, VICTOR (MD)
Entity Type:Individual
Prefix:DR
First Name:VICTOR
Middle Name:
Last Name:ELOY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2 MEMORIAL DRIVE
Mailing Address - Street 2:SUITE 101
Mailing Address - City:DECATUR
Mailing Address - State:IL
Mailing Address - Zip Code:62526-1589
Mailing Address - Country:US
Mailing Address - Phone:217-875-2640
Mailing Address - Fax:217-875-3101
Practice Address - Street 1:2 MEMORIAL DRIVE
Practice Address - Street 2:SUITE 101
Practice Address - City:DECATUR
Practice Address - State:IL
Practice Address - Zip Code:62526-1589
Practice Address - Country:US
Practice Address - Phone:217-875-2640
Practice Address - Fax:217-875-3101
Is Sole Proprietor?:No
Enumeration Date:2006-07-06
Last Update Date:2016-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036064037207R00000X
IL036964937207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL036064037Medicaid
IL729660Medicare ID - Type Unspecified
IL036064037Medicaid