Provider Demographics
NPI:1174899967
Name:VINCENT, NERINE TESS (MD)
Entity type:Individual
Prefix:
First Name:NERINE
Middle Name:TESS
Last Name:VINCENT
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4309 W MEDICAL CENTER DR STE B201
Mailing Address - Street 2:
Mailing Address - City:MCHENRY
Mailing Address - State:IL
Mailing Address - Zip Code:60050-8417
Mailing Address - Country:US
Mailing Address - Phone:847-802-7280
Mailing Address - Fax:815-759-4602
Practice Address - Street 1:4309 W MEDICAL CENTER DR STE B201
Practice Address - Street 2:
Practice Address - City:MCHENRY
Practice Address - State:IL
Practice Address - Zip Code:60050-8417
Practice Address - Country:US
Practice Address - Phone:847-802-7280
Practice Address - Fax:815-759-4602
Is Sole Proprietor?:No
Enumeration Date:2012-03-27
Last Update Date:2024-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036144272207RI0200X
WI64373207RI0200X
ND15504207RI0200X
390200000X
OH35.138313207RI0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0200XAllopathic & Osteopathic PhysiciansInternal MedicineInfectious Disease
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program