Healthcare Provider Details

I. General information

NPI: 1144412677
Provider Name (Legal Business Name): VASSYL A LONCHYNA MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/17/2007
Last Update Date: 08/17/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1725 W HARRISON ST SUITE 1156
CHICAGO IL
60612-3841
US

IV. Provider business mailing address

828 S WASHINGTON ST
HINSDALE IL
60521-4531
US

V. Phone/Fax

Practice location:
  • Phone: 312-563-2762
  • Fax: 312-563-4388
Mailing address:
  • Phone: 630-654-3341
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RC0200X
TaxonomyCritical Care Medicine (Internal Medicine) Physician
License Number036056029
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: