Healthcare Provider Details

I. General information

NPI: 1730896390
Provider Name (Legal Business Name): VRB VASCULAR, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/03/2022
Last Update Date: 11/22/2024
Certification Date: 11/22/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1845 E RAND RD STE 100
ARLINGTON HEIGHTS IL
60004-4359
US

IV. Provider business mailing address

1845 E RAND RD STE 100
ARLINGTON HEIGHTS IL
60004-4359
US

V. Phone/Fax

Practice location:
  • Phone: 224-526-8346
  • Fax:
Mailing address:
  • Phone: 224-526-8346
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code202K00000X
TaxonomyPhlebology Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. VERA BOUTROS
Title or Position: PHYSICIAN OWNER
Credential: MD
Phone: 224-526-8346