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Contact Information

KETAN C VYAS, MD
610 N COURT ST
GRAYVILLE, IL62844
 Phone: 618-375-7101
 Fax: 618-375-7183
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Internal Medicine

207R00000X 11 Physician/Internal Medicine
Indicates primary specialty

NPI Profile & details for KETAN C VYAS · (Male)

NPI Number 1346216215
Status Active
Credentials MD
Entity Individual
Enumeration date 02/28/2006
Last updated 04/22/2010 - About 16 years ago
Sole proprietor 1 No
Identifiers
  • IL License # 036091476
  • IN License # 01043808A
  • IL Medicaid 036091476
  • Other 282819 HEALTHLINK
  • Other 110136426 RAILROAD MEDICARE
  • IL Other 0009707064 BLUE CROSS
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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