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NPI Code Detail

MEDICARE: MR. VITALIY A VULYKH APN

MEDICARE: MR. VITALIY A VULYKH APN
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1367500000XCertified Registered Nurse Anesthetist209011848IL

General Provider Information

NPI Number : 1013310606
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. VITALIY A VULYKH APN
Provider Business Mailing Address
First Line : 800 BIESTERFIELD RD
Second Line :
City : ELK GROVE VLG
State : IL
Zip : 60007-3361
Country : US
Telephone Number : 847-437-5500
Fax Number :
Provider Business Practice Location Address
First Line : 800 BIESTERFIELD RD
Second Line :
City : ELK GROVE VLG
State : IL
Zip : 60007-3361
Country : US
Telephone Number : 847-437-5500
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/26/2014
Last Update Date : 01/30/2023

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