Healthcare Provider Details
I. General information
NPI: 1841794237
Provider Name (Legal Business Name): VSH HEALTH LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 03/20/2018
Last Update Date: 05/29/2019
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
19710 GOVERNORS HWY STE 1
FLOSSMOOR IL
60422-2081
US
IV. Provider business mailing address
19710 GOVERNORS HWY STE 1
FLOSSMOOR IL
60422-2081
US
V. Phone/Fax
- Phone: 708-888-2231
- Fax:
- Phone:
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 363LF0000X |
| Taxonomy | Family Nurse Practitioner |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
VELISCIA
HODGES
Title or Position: OWNER
Credential: APN, FNP-C
Phone: 708-785-0178