MEDICARE: VITAS HEALTHCARE CORPORATION OF ILLINOIS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy
1	207RH0002X	Hospice and Palliative Medicine (Internal Medicine) Physician
2	363L00000X	Nurse Practitioner
3	207QH0002X	Hospice and Palliative Medicine (Family Medicine) Physician

General Provider Information

NPI Number	:	1366218430
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	VITAS HEALTHCARE CORPORATION OF ILLINOIS

Provider Business Mailing Address
First Line	:	255 E 5TH ST STE 1050
Second Line	:
City	:	CINCINNATI
State	:	OH
Zip	:	45202-4121
Country	:	US
Telephone Number	:	513-618-2243
Fax Number	:

Provider Business Practice Location Address
First Line	:	1340 S DAMEN AVE STE 200
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60608-1170
Country	:	US
Telephone Number	:	312-997-7200
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT & CEO
Name	:	NICHOLAS WESTFALL
Credential	:
Telephone Number	:	513-618-2240

Provider Enumeration Date	:	11/30/2023
Last Update Date	:	11/30/2023

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Directions to “VITAS HEALTHCARE CORPORATION OF ILLINOIS ” Practice Location

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