Vicik, Gary John

Vicik, Gary John is an individual health care provider with primary practice located at 3608 W Main St , Belleville IL 62226-6225. He recently has only one registered license in Other Service Providers / Specialist, which is considered as his primary health care specialty. Vicik, Gary John can be contacted via phone (618) 397-6605.

Contact Information

Primary practice address
3608 W Main St Belleville IL 62226-6225
Phone: (618) 397-6605
Fax: (618) 277-1251
Website:
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Health care specialties

SpecialtyCodeLicense #State
Other Service Providers / Specialist 174400000X 36-49185 Illinois

Profile Details

NPI number 1295708212
LBN Legal business name Vicik, Gary John
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Feb 9th, 2006
Last updated May 21st, 2012 - about 14 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1295708212 NPPES
Other 0778106 AETNA
Other 42561V34432 AETNA
Other 8215117 AETNA
MEDICAID 036049185 AETNA
Other 42561V34432 AETNA
Other STL0307017 AETNA
Other 101263 AETNA
Other 202982 AETNA
Other 11512 AETNA

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