Provider Demographics
NPI:1013123769
Name:VANCURA, EMIL JAY (MD)
Entity type:Individual
Prefix:DR
First Name:EMIL
Middle Name:JAY
Last Name:VANCURA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:181 SCOTTSWOOD RD
Mailing Address - Street 2:
Mailing Address - City:RIVERSIDE
Mailing Address - State:IL
Mailing Address - Zip Code:60546-2221
Mailing Address - Country:US
Mailing Address - Phone:708-447-6500
Mailing Address - Fax:708-447-6500
Practice Address - Street 1:181 SCOTTSWOOD RD
Practice Address - Street 2:
Practice Address - City:RIVERSIDE
Practice Address - State:IL
Practice Address - Zip Code:60546-2221
Practice Address - Country:US
Practice Address - Phone:708-447-6500
Practice Address - Fax:708-447-6500
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
IL2083X0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2083X0100XAllopathic & Osteopathic PhysiciansPreventive MedicineOccupational Medicine