Healthcare Provider Details

I. General information

NPI: 1871227140
Provider Name (Legal Business Name): STRIVE MEDICAL VBE OF ILLINOIS PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/13/2022
Last Update Date: 06/11/2026
Certification Date: 06/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1125 17TH ST STE 1000
DENVER CO
80202-2043
US

IV. Provider business mailing address

1125 17TH ST STE 1000
DENVER CO
80202-2043
US

V. Phone/Fax

Practice location:
  • Phone: 855-962-4638
  • Fax:
Mailing address:
  • Phone: 855-962-4638
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RN0300X
TaxonomyNephrology Physician
License Number
License Number State

VIII. Authorized Official

Name: LAURA CHANDHOK
Title or Position: DIRECTOR, SUPPORT OPERATIONS
Credential:
Phone: 855-962-4638