Provider Demographics
NPI:1912439951
Name:GOYAL, VINAY (DO)
Entity Type:Individual
Prefix:
First Name:VINAY
Middle Name:
Last Name:GOYAL
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1750 N RANDALL RD STE 210
Mailing Address - Street 2:
Mailing Address - City:ELGIN
Mailing Address - State:IL
Mailing Address - Zip Code:60123-7903
Mailing Address - Country:US
Mailing Address - Phone:847-888-9000
Mailing Address - Fax:847-888-9001
Practice Address - Street 1:1750 N RANDALL RD STE 210
Practice Address - Street 2:
Practice Address - City:ELGIN
Practice Address - State:IL
Practice Address - Zip Code:60123-7903
Practice Address - Country:US
Practice Address - Phone:847-888-9000
Practice Address - Fax:847-888-9001
Is Sole Proprietor?:No
Enumeration Date:2017-03-29
Last Update Date:2022-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036.159477207Y00000X
390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngology