Provider Demographics
NPI:1982985032
Name:EMPACT EMERGENCY PHYSICIANS LLC
Entity type:Organization
Organization Name:EMPACT EMERGENCY PHYSICIANS LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:F
Authorized Official - Last Name:VIK
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:630-476-1171
Mailing Address - Street 1:PO BOX 5997
Mailing Address - Street 2:DEPT. 20-7009
Mailing Address - City:CAROL STREAM
Mailing Address - State:IL
Mailing Address - Zip Code:60197-5997
Mailing Address - Country:US
Mailing Address - Phone:630-734-0200
Mailing Address - Fax:630-371-0733
Practice Address - Street 1:2000 OGDEN AVE
Practice Address - Street 2:
Practice Address - City:AURORA
Practice Address - State:IL
Practice Address - Zip Code:60504-7222
Practice Address - Country:US
Practice Address - Phone:630-734-0200
Practice Address - Fax:630-371-0733
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-09-02
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL282N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282N00000XHospitalsGeneral Acute Care Hospital