MEDICARE: VRB VASCULAR, PLLC

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207Q00000X	Family Medicine Physician
2	202K00000X	Phlebology Physician

General Provider Information

NPI Number	:	1730896390
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	VRB VASCULAR, PLLC

Provider Business Mailing Address
First Line	:	1845 E RAND RD STE 100
Second Line	:
City	:	ARLINGTON HEIGHTS
State	:	IL
Zip	:	60004-4359
Country	:	US
Telephone Number	:	224-526-8346
Fax Number	:

Provider Business Practice Location Address
First Line	:	1845 E RAND RD STE 100
Second Line	:
City	:	ARLINGTON HEIGHTS
State	:	IL
Zip	:	60004-4359
Country	:	US
Telephone Number	:	224-526-8346
Fax Number	:

Authorized Official
Title or Position	:	PHYSICIAN OWNER
Name	:	DR. VERA BOUTROS
Credential	:	MD
Telephone Number	:	224-526-8346

Provider Enumeration Date	:	11/03/2022
Last Update Date	:	11/22/2024

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