Provider Demographics
NPI:1194354829
Name:VALIKA, AQIL
Entity type:Individual
Prefix:
First Name:AQIL
Middle Name:
Last Name:VALIKA
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:34 RIVER RIDGE DR
Mailing Address - Street 2:
Mailing Address - City:SLEEPY HOLLOW
Mailing Address - State:IL
Mailing Address - Zip Code:60118-3119
Mailing Address - Country:US
Mailing Address - Phone:224-402-4382
Mailing Address - Fax:
Practice Address - Street 1:6215 E STATE ST
Practice Address - Street 2:
Practice Address - City:ROCKFORD
Practice Address - State:IL
Practice Address - Zip Code:61108-2514
Practice Address - Country:US
Practice Address - Phone:815-399-7777
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-04-04
Last Update Date:2020-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL019.0327021223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice