Provider Demographics
NPI:1194703892
Name:VLCEK, IRENA (MD)
Entity type:Individual
Prefix:MRS
First Name:IRENA
Middle Name:
Last Name:VLCEK
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:IRENA
Other - Middle Name:
Other - Last Name:DANCZIK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:8031 CAMPUS DELIVERY
Mailing Address - Street 2:
Mailing Address - City:FORT COLLINS
Mailing Address - State:CO
Mailing Address - Zip Code:80523-8031
Mailing Address - Country:US
Mailing Address - Phone:970-491-7121
Mailing Address - Fax:970-491-6965
Practice Address - Street 1:8031 CAMPUS DELIVERY
Practice Address - Street 2:
Practice Address - City:FORT COLLINS
Practice Address - State:CO
Practice Address - Zip Code:80523-8031
Practice Address - Country:US
Practice Address - Phone:970-491-7121
Practice Address - Fax:970-491-6965
Is Sole Proprietor?:No
Enumeration Date:2006-01-04
Last Update Date:2024-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO477152084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
WYW21060Medicare PIN