Healthcare Provider Details

I. General information

NPI: 1699302521
Provider Name (Legal Business Name): VASILIOS KALAS MD PHD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/23/2020
Last Update Date: 08/27/2026
Certification Date: 08/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

25 N WINFIELD RD STE 420
WINFIELD IL
60190-1379
US

IV. Provider business mailing address

25 N WINFIELD RD STE 420
WINFIELD IL
60190-1379
US

V. Phone/Fax

Practice location:
  • Phone: 630-682-8700
  • Fax: 630-352-5582
Mailing address:
  • Phone: 630-682-8700
  • Fax: 630-352-5582

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License Number036164255
License Number StateIL
# 2
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code207RG0100X
TaxonomyGastroenterology Physician
License Number036164255
License Number StateIL
# 4
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number1699302521
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: