Vmd Primary Providers Of North Florida PLLC
Family Medicine in Chicago, IL. Organization (NPI-2).
NPI number1891304697
StatusActive
Last updated in NPPESJan 14, 2025
Details
- NPI
- 1891304697
- Entity type
- Organization (NPI-2)
- Legal business name
- Vmd Primary Providers Of North Florida PLLC
- Organization subpart
- No
- Enumeration date
- Jul 28, 2020
- Certification date
- Jan 14, 2025
- Last updated
- Jan 14, 2025
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 207Q00000X | Family Medicine | – | – | Yes |
| 207R00000X | Internal Medicine | – | – | |
| 363A00000X | Physician Assistant | – | – | |
| 363L00000X | Nurse Practitioner | – | – |
Practice location
125 S Clark St Ste 900Chicago, IL 60603-4043
Phone 346-980-2701 · Fax 713-932-0437
Mailing address
4650 Westway Park Blvd Ste 206Houston, TX 77041-2006
Authorized official
Rebecca Rager
Director
8449690686
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