Healthcare Provider Details
I. General information
NPI: 1346801610
Provider Name (Legal Business Name): VAS NETWORKING SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 06/26/2019
Last Update Date: 06/26/2019
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
6330 S KING DRIVE AVE
CHICAGO IL
60637-3115
US
IV. Provider business mailing address
9135 SO MAY STREET
CHICAGO IL
60620-3542
US
V. Phone/Fax
- Phone: 708-690-4464
- Fax:
- Phone: 708-690-4464
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 172V00000X |
| Taxonomy | Community Health Worker |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 251T00000X |
| Taxonomy | PACE Provider Organization |
| License Number | |
| License Number State | |
| # 3 | |
| Primary Taxonomy | N |
| Taxonomy Code | 253Z00000X |
| Taxonomy | In Home Supportive Care Agency |
| License Number | |
| License Number State | |
| # 4 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 251B00000X |
| Taxonomy | Case Management Agency |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
VALERIE
ANN
SILAS
Title or Position: EXECUTIVE DIRECTOR
Credential:
Phone: 708-690-4464