Healthcare Provider Details

I. General information

NPI: 1740902238
Provider Name (Legal Business Name): VELOCITY HEALTH PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/13/2022
Last Update Date: 10/06/2022
Certification Date: 10/06/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8348 LINCOLN AVE
SKOKIE IL
60077-2436
US

IV. Provider business mailing address

8348 LINCOLN AVE
SKOKIE IL
60077-2436
US

V. Phone/Fax

Practice location:
  • Phone: 815-215-8555
  • Fax:
Mailing address:
  • Phone: 815-215-8555
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: AZRA FLOWERS
Title or Position: MANAGER
Credential: APRN
Phone: 815-215-8555