Provider Demographics
NPI:1215671391
Name:DOAN, VINCENT (DO)
Entity type:Individual
Prefix:
First Name:VINCENT
Middle Name:
Last Name:DOAN
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:330 STEVENS CT
Mailing Address - Street 2:
Mailing Address - City:GRAYSLAKE
Mailing Address - State:IL
Mailing Address - Zip Code:60030-3533
Mailing Address - Country:US
Mailing Address - Phone:847-323-7056
Mailing Address - Fax:
Practice Address - Street 1:330 STEVENS CT
Practice Address - Street 2:
Practice Address - City:GRAYSLAKE
Practice Address - State:IL
Practice Address - Zip Code:60030-3533
Practice Address - Country:US
Practice Address - Phone:847-323-7056
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-04-25
Last Update Date:2022-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program