NPIMap

Organization Active NPI

Vcfe of Lake County, Inc

  • Vascular Surgery Physician
  • Gurnee, IL
National Provider Identifier
1821137183
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Vascular Surgery PhysicianTaxonomy code 2086S0129X
Legal business name
VCFE OF LAKE COUNTY, INC
Practice address
1445 N Hunt Club Rd
Suite 103
Gurnee, IL 60031-2603
Phone
(847) 856-2534
Fax
(847) 856-2534
NPI assigned
Feb 5, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Timothy Ryan, MD
Title
President
Phone
(847) 856-2534

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Vascular Surgery PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 2086S0129X Primary

Addresses

Primary practice location

1445 N Hunt Club Rd
Suite 103
Gurnee, IL 60031-2603

Mailing address

1445 N Hunt Club Rd
Suite 103
Gurnee, IL 60031-2603
Phone (847) 856-2534

National Provider Directory

National Provider Directory

Locations

1445 N Hunt Club Rd
Ste 103
Gurnee, IL 60031
Phone (515) 223-0592

Practitioners & affiliated clinicians

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1170633600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1821137183",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1445 N HUNT CLUB RD",
            "address_2": "SUITE 103",
            "city": "GURNEE",
            "state": "IL",
            "postal_code": "600312603",
            "telephone_number": "847-856-2534",
            "fax_number": "847-856-2534"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1445 N HUNT CLUB RD",
            "address_2": "SUITE 103",
            "city": "GURNEE",
            "state": "IL",
            "postal_code": "600312603",
            "telephone_number": "847-856-2534",
            "fax_number": "847-856-2534"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VCFE OF LAKE COUNTY, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-05",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "RYAN",
        "authorized_official_first_name": "TIMOTHY",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "847-856-2534",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "2086S0129X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Surgery, Vascular Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Gurnee, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.