Provider Demographics
NPI:1588144497
Name:VIP 2U PC
Entity type:Organization
Organization Name:VIP 2U PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:R
Authorized Official - Last Name:HAEBICH
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:630-715-9738
Mailing Address - Street 1:477 E BUTTERFIELD RD STE 500
Mailing Address - Street 2:
Mailing Address - City:LOMBARD
Mailing Address - State:IL
Mailing Address - Zip Code:60148-4800
Mailing Address - Country:US
Mailing Address - Phone:630-715-9738
Mailing Address - Fax:630-368-1104
Practice Address - Street 1:477 E BUTTERFIELD RD STE 500
Practice Address - Street 2:
Practice Address - City:LOMBARD
Practice Address - State:IL
Practice Address - Zip Code:60148-4800
Practice Address - Country:US
Practice Address - Phone:630-715-9738
Practice Address - Fax:630-368-1104
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-08-20
Last Update Date:2018-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty