Healthcare Provider Details

I. General information

NPI: 1205071818
Provider Name (Legal Business Name): VICENTE F SAHIG MD SC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/10/2008
Last Update Date: 01/02/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2555 LINCOLN HWY SUITE 106
OLYMPIA FIELDS IL
60461-1936
US

IV. Provider business mailing address

2555 LINCOLN HWY SUITE 106
OLYMPIA FIELDS IL
60461-1936
US

V. Phone/Fax

Practice location:
  • Phone: 708-481-7555
  • Fax: 708-481-7556
Mailing address:
  • Phone: 708-481-7555
  • Fax: 708-481-7556

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QC1500X
TaxonomyCommunity Health Clinic/Center
License Number036.036524
License Number StateIL

VIII. Authorized Official

Name: DR. VICENTE FERMIN SAHIG
Title or Position: PRESIDENT
Credential: M.D.
Phone: 708-481-7555