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VITAL FAMILY HEALTHCARE LLC. NPI 1417647066


NPI Information

NPI: 1417647066
Provider Name: VITAL FAMILY HEALTHCARE LLC.

Doing Business As: CLINIC OF BELVIDERE

Classification: Clinic/Center - 261Q00000X
Entity Type: Organization

CLIA Number: 14D2283030

Address:
1004 LOGAN AVE
BELVIDERE, IL
ZIP 61008
Phone: (815) 482-6365
Get Directions

VITAL FAMILY HEALTHCARE LLC. is a clinic center in Belvidere, IL. The provider is a facility or distinct part of one used for the diagnosis and treatment of outpatients. Clinic/Center is irregularly defined, sometimes being limited to organizations serving specialized treatment requirements or distinct patient/client groups (e.g., radiology, poor, and public health). VITAL FAMILY HEALTHCARE LLC. NPI is 1417647066. The provider is registered as an organization entity type and is a single specialty group.
The provider Is Doing Business As Clinic Of Belvidere.

The provider's business location address is:

1004 LOGAN AVE
BELVIDERE, IL
ZIP 61008
Phone: (815) 482-6365

The provider's authorized official is Jaclyn Newhart .
The authorized official title is Manager and has the following contact phone number (708) 653-3496.

The CLIA number assigned to this NPI record is 14D2283030 - community clinic with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 5/8/2023 and was last updated on 9/29/2023.


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
1363L00000XNurse PractitionerNo
2261Q00000XClinic/CenterYes

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: 5/5/2024

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.