Lytchakov, Vladimir A

Lytchakov, Vladimir A is an individual health care provider with primary practice located at 1025 S 6Th St , Springfield IL 62703-2403. He recently has only one registered license in Allopathic & Osteopathic Physicians / Internal Medicine, which is considered as his primary health care specialty. Lytchakov, Vladimir A can be contacted via phone (217) 528-7541.

Contact Information

Primary practice address
1025 S 6Th St Springfield IL 62703-2403
Phone: (217) 528-7541
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Internal Medicine 207R00000X 37260 Kentucky
Allopathic & Osteopathic Physicians / Internal Medicine 207R00000X 036121326 Illinois

Profile Details

NPI number 1184617201
LBN Legal business name Lytchakov, Vladimir A
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 24th, 2005
Last updated May 21st, 2020 - about 5 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1184617201 NPPES
Illinois Other R02387 MEDICARE PTAN
Illinois MEDICAID 036121326 MEDICARE PTAN

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