Healthcare Provider Details

I. General information

NPI: 1255544029
Provider Name (Legal Business Name): ANOOP KUMAR VERMANI M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/08/2007
Last Update Date: 04/09/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

25 N WINFIELD RD
WINFIELD IL
60190-1295
US

IV. Provider business mailing address

25 N WINFIELD RD
WINFIELD IL
60190-1295
US

V. Phone/Fax

Practice location:
  • Phone: 630-933-4056
  • Fax: 630-933-4057
Mailing address:
  • Phone: 630-933-4056
  • Fax: 630-933-4057

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number036124070
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: