Healthcare Provider Details

I. General information

NPI: 1174410724
Provider Name (Legal Business Name): VIVIANA RICE
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/18/2025
Last Update Date: 06/18/2025
Certification Date: 06/18/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

155 E BRUSH HILL RD
ELMHURST IL
60126-5658
US

IV. Provider business mailing address

733 N LOMBARD ST
ELMHURST IL
60126-1727
US

V. Phone/Fax

Practice location:
  • Phone: 847-951-5518
  • Fax:
Mailing address:
  • Phone: 847-951-5518
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WE0003X
TaxonomyEmergency Registered Nurse
License Number041447785
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: