Provider Demographics
NPI:1467409243
Name:SANDAS, VASILIKE J (MD)
Entity type:Individual
Prefix:DR
First Name:VASILIKE
Middle Name:J
Last Name:SANDAS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:6300 S. KINGERY HWY
Mailing Address - Street 2:SUITE 404
Mailing Address - City:WILLOWBROOK
Mailing Address - State:IL
Mailing Address - Zip Code:60527
Mailing Address - Country:US
Mailing Address - Phone:630-789-3338
Mailing Address - Fax:630-789-3394
Practice Address - Street 1:6300 KINGERY HWY
Practice Address - Street 2:SUITE 404
Practice Address - City:WILLOW BROOK
Practice Address - State:IL
Practice Address - Zip Code:60527-2248
Practice Address - Country:US
Practice Address - Phone:630-789-3338
Practice Address - Fax:630-789-3394
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-05-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
IL208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation
Provider Identifiers
StateIdentifier IDID TypeIssuer
ILG12586Medicare UPIN
ILK14935Medicare ID - Type Unspecified
ILK18997Medicare ID - Type Unspecified