Vancauwelaert, Tony R.

Vancauwelaert, Tony R. is an sole proprietor health care provider with primary practice located at 2740 W Foster Ave Suite 214, Chicago IL 60625-3500. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Family Medicine, Allopathic & Osteopathic Physicians / Adolescent Medicine. Allopathic & Osteopathic Physicians / Family Medicine is his primary health care specialty. Vancauwelaert, Tony R. can be contacted via phone (773) 506-2000.

Contact Information

Primary practice address
2740 W Foster Ave Suite 214 Chicago IL 60625-3500
Fax: (773) 506-2668
Website:

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X 036092385 Illinois
Allopathic & Osteopathic Physicians / Adolescent Medicine 207QA0000X 036092385 Illinois

Profile Details

NPI number 1649386822
LBN Legal business name Vancauwelaert, Tony R.
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Aug 21st, 2006
Last updated Feb 19th, 2010 - about 14 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 1649386822 NPPES
Illinois MEDICAID 036092385

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