Healthcare Provider Details

I. General information

NPI: 1124659321
Provider Name (Legal Business Name): VITAE HEALTH MEDICAL TENNESSEE PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/28/2020
Last Update Date: 03/25/2025
Certification Date: 03/25/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

141 N MCLEAN BLVD
MEMPHIS TN
38104-2693
US

IV. Provider business mailing address

3450 OAKTON ST STE 300
SKOKIE IL
60076-2951
US

V. Phone/Fax

Practice location:
  • Phone: 224-777-8034
  • Fax:
Mailing address:
  • Phone: 224-777-8034
  • Fax: 224-236-4900

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number
License Number State

VIII. Authorized Official

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