Healthcare Provider Details

I. General information

NPI: 1184759219
Provider Name (Legal Business Name): PATRICIA A VINAJA P.T.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/22/2007
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1951 W 19TH ST
CHICAGO IL
60608-2647
US

IV. Provider business mailing address

1726 N 77TH CT
ELMWOOD PARK IL
60707-4110
US

V. Phone/Fax

Practice location:
  • Phone: 312-997-2021
  • Fax:
Mailing address:
  • Phone: 708-456-3548
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2251P0200X
TaxonomyPediatric Physical Therapist
License Number
License Number StateIL
# 2
Primary TaxonomyN
Taxonomy Code174400000X
TaxonomySpecialist
License Number
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: