Healthcare Provider Details

I. General information

NPI: 1609786433
Provider Name (Legal Business Name): JOHN JOSEPH VESELY JR. RN
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/11/2026
Last Update Date: 09/11/2026
Certification Date: 09/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

450 W HIGHWAY 22
BARRINGTON IL
60010-1999
US

IV. Provider business mailing address

5327 W VALLEY DR
RICHMOND IL
60071-9451
US

V. Phone/Fax

Practice location:
  • Phone: 848-842-4100
  • Fax:
Mailing address:
  • Phone: 815-219-0850
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WC0200X
TaxonomyCritical Care Medicine Registered Nurse
License Number041.341770
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: