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General NPI Number Information
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NPI Number | 1407876832
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Entity Type | Organization
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Legal Business Name | RONALD J VASU MD SC
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Dates
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Enumeration Date | 07/20/2006
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Last Update Date | 05/28/2013
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Provider Practice Location Address
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Address Line | 233 E ERIE ST SUITE 605
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City | CHICAGO
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State | IL
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Zip | 60611-2926
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Country | US
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Telephone | 312-642-2434
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Fax |
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Provider Business Mailing Address
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Address Line | 233 E ERIE ST SUITE 605
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City | CHICAGO
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State | IL
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Zip | 60611-2926
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Country | US
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Telephone | 312-642-2434
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. RONALD J VASU
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Credential | M.D.
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Telephone | 312-642-2434
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | 036039369
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License Number State | IL
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