Healthcare Provider Details

I. General information

NPI: 1750068748
Provider Name (Legal Business Name): VITAE HEALTH CLINICAL SERVICES MARYLAND LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/30/2023
Last Update Date: 03/25/2025
Certification Date: 03/25/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3330 WILKENS AVE
BALTIMORE MD
21229-4610
US

IV. Provider business mailing address

415 W GOLF ROD STE 26
ARLINGTON HEIGHTS IL
60005
US

V. Phone/Fax

Practice location:
  • Phone: 410-525-1544
  • Fax:
Mailing address:
  • Phone: 224-777-8045
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: YITZCHAK FREUND
Title or Position: CHIEF OPERATING OFFICER
Credential:
Phone: 224-777-8045