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General NPI Number Information
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NPI Number | 1629234851
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Entity Type | Individual
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Provider Name | VINCENT BOLISAY VARGAS M.D.
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Gender | Male
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Dates
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Enumeration Date | 08/07/2008
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Last Update Date | 02/09/2026
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Provider Practice Location Address
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Address Line | 2835 N SHEFFIELD AVE STE 500
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City | CHICAGO
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State | IL
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Zip | 60657-5084
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Country | US
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Telephone | 773-296-2400
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Fax | 888-720-4714
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Provider Business Mailing Address
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Address Line | 1131 W ADDISON ST APT 1
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City | CHICAGO
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State | IL
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Zip | 60613-7064
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Country | US
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Telephone | 773-296-2400
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Fax | 888-720-4714
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 036151210
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License Number State | IL
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Taxonomy #2
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | MD443170
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License Number State | PA
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