Healthcare Provider Details

I. General information

NPI: 1336951458
Provider Name (Legal Business Name): VITALTOUCH HEALTH NETWORK INCORPORATED
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/24/2025
Last Update Date: 05/23/2026
Certification Date: 05/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4749 LINCOLN MALL DR STE 204
MATTESON IL
60443-3806
US

IV. Provider business mailing address

4749 LINCOLN MALL DR STE 204
MATTESON IL
60443-3806
US

V. Phone/Fax

Practice location:
  • Phone: 708-898-8831
  • Fax:
Mailing address:
  • Phone: 708-898-8831
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code376J00000X
TaxonomyHomemaker
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State

VIII. Authorized Official

Name: MR. IFEANYICHUKWU C EZURIKE
Title or Position: CEO/PRESIDENT
Credential:
Phone: 708-898-8831