Healthcare Provider Details

I. General information

NPI: 1083195564
Provider Name (Legal Business Name): VIP 2U, LTD.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/23/2018
Last Update Date: 02/13/2024
Certification Date: 02/13/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

360 W BUTTERFIELD RD STE 325
ELMHURST IL
60126-5088
US

IV. Provider business mailing address

360 W BUTTERFIELD RD STE 325
ELMHURST IL
60126-5088
US

V. Phone/Fax

Practice location:
  • Phone: 312-728-4728
  • Fax: 312-728-4729
Mailing address:
  • Phone: 312-728-4728
  • Fax: 312-728-4729

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State

VIII. Authorized Official

Name: JENNIFER ZAMORA
Title or Position: DIRECTOR
Credential:
Phone: 131-272-8472