Illera, Vivian A
Illera, Vivian A is an individual health care provider with primary practice located at 1921 N Webb Rd , Wichita KS 67206-3405. She recently has only one registered license in Allopathic & Osteopathic Physicians / Rheumatology, which is considered as her primary health care specialty. Illera, Vivian A can be contacted via phone (316) 612-4815.Contact Information
Primary practice address
1921 N Webb Rd
Wichita KS 67206-3405
Phone: (316) 612-4815
Fax: (316) 681-0244
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Rheumatology | 207RR0500X | 04-25436 | Kansas |
Profile Details
| NPI number | 1790741148 |
|---|---|
| LBN Legal business name | Illera, Vivian A |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Apr 25th, 2006 |
| Last updated | Jul 11th, 2011 - about 13 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1790741148 | NPPES |
| Kansas | MEDICAID | 100170460B |
Popular Providers
-
Shahouri, Shadi Hassan
1921 N Webb Rd , Wichita KS 67206-3405 -
Griffin, John W.
10101 Se Main St Ste 2001, Portland OR 97216-2457 -
Rohr, Melanie Kay
1921 N Webb Rd , Wichita KS 67206-3405 -
Shaver, Timothy S
1921 N Webb Rd , Wichita KS 67206-3405 -
Reynolds, Teresa A
3311 E Murdock St , Wichita KS 67208-3054 -
Fagundus, Duncan
1850 W Arlington Blvd , Greenville NC 27834-5704 -
Mortensen, Steen E
3311 E Murdock St , Wichita KS 67208-3054 -
Pasniciuc, Maria I
5794 Widewaters Pkwy , Syracuse NY 13214