Healthcare Provider Details

I. General information

NPI: 1831849132
Provider Name (Legal Business Name): VIOS FERTILITY INSTITUTE CHICAGO
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/28/2022
Last Update Date: 03/28/2022
Certification Date: 03/15/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2500 N MAYFAIR RD STE 420
WAUWATOSA WI
53226-1443
US

IV. Provider business mailing address

333 S DESPLAINES ST STE 201
CHICAGO IL
60661-5514
US

V. Phone/Fax

Practice location:
  • Phone: 262-518-7448
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207VE0102X
TaxonomyReproductive Endocrinology Physician
License Number
License Number State

VIII. Authorized Official

Name: MERCEDES POSADAS
Title or Position: CREDENTIALING SPECIALIST
Credential:
Phone: 847-773-0029