VITALITY FOREVER HEALTHCARE P.C NPI 1396162392

NPI Information

NPI: 1396162392
Provider Name: VITALITY FOREVER HEALTHCARE P.C
Classification: Nurse Practitioner - 363LF0000X
Entity Type: Organization

Specialization: Family

CLIA Number: 14D2140766

Address:
2107 N CHESTNUT AVE
ARLINGTON HEIGHTS, IL
ZIP 60004
Phone: (224) 628-3643
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VITALITY FOREVER HEALTHCARE P.C is a family nurse practitioner in Arlington Heights, IL. VITALITY FOREVER HEALTHCARE P.C NPI is 1396162392. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

2107 N CHESTNUT AVE
ARLINGTON HEIGHTS, IL
ZIP 60004-023
Phone: (224) 628-3643
Fax: (224) 333-7063

The provider's authorized official is Rodion Levin .
The authorized official title is Family Nurse Practitioner and has the following contact phone number (224) 628-3643.

The CLIA number assigned to this NPI record is 14D2140766 - other practitioner with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 3/27/2014 and was last updated on 3/27/2014.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	363LF0000X	Nurse Practitioner	Family	209010709	ILLINOIS	Yes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

NPI Synchronization or Removal

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