Healthcare Provider Details

I. General information

NPI: 1982985032
Provider Name (Legal Business Name): EMPACT EMERGENCY PHYSICIANS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/02/2011
Last Update Date: 07/21/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2000 OGDEN AVE
AURORA IL
60504-7222
US

IV. Provider business mailing address

PO BOX 5997 DEPT. 20-7009
CAROL STREAM IL
60197-5997
US

V. Phone/Fax

Practice location:
  • Phone: 630-734-0200
  • Fax: 630-371-0733
Mailing address:
  • Phone: 630-734-0200
  • Fax: 630-371-0733

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code282N00000X
TaxonomyGeneral Acute Care Hospital
License Number
License Number StateIL

VIII. Authorized Official

Name: DR. DAVID F VIK
Title or Position: DIRECTOR
Credential: MD
Phone: 630-476-1171