Healthcare Provider Details

I. General information

NPI: 1215598891
Provider Name (Legal Business Name): VERO CLINICS INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/25/2019
Last Update Date: 04/26/2023
Certification Date: 04/26/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1192 E PERSHING RD
DECATUR IL
62526-4753
US

IV. Provider business mailing address

1192 E PERSHING RD
DECATUR IL
62526-4753
US

V. Phone/Fax

Practice location:
  • Phone: 217-615-1144
  • Fax:
Mailing address:
  • Phone: 217-615-1144
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261Q00000X
TaxonomyClinic/Center
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QM2500X
TaxonomyMedical Specialty Clinic/Center
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code207VG0400X
TaxonomyGynecology Physician
License Number
License Number State

VIII. Authorized Official

Name: JEFFREY PFEIFFER
Title or Position: GYNECOLOGIST
Credential: MD
Phone: 217-620-5542