| NPI | 1396162392 |
|---|---|
| Doing Business As | VITALITY URGENT CARE |
| Former Legal Business Name | VITALITY FOREVER HEALTHCARE P.C |
| Entity Type | Organization |
| Authorized Contact | RODION LEVIN Provider 224-628-3643 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: IL 209010709) |
| Enumeration Date | 2014-03-27 |
| Last Update Date | 2024-01-27 |