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General NPI Number Information
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NPI Number | 1174855290
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Entity Type | Individual
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Provider Name | JOSEPH J. VITEZ
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Gender | Male
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Dates
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Enumeration Date | 02/01/2010
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Last Update Date | 02/01/2010
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Provider Practice Location Address
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Address Line | 2615 HARRISON ST
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City | BELLWOOD
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State | IL
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Zip | 60104-2450
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Country | US
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Telephone | 708-493-0199
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Fax | 708-493-9683
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Provider Business Mailing Address
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Address Line | 2615 HARRISON ST
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City | BELLWOOD
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State | IL
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Zip | 60104-2450
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Country | US
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Telephone | 708-493-0199
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Fax | 708-493-9683
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2471N0900X
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Taxonomy Name | Nuclear Medicine Technology Radiologic Technologist
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License Number | 500493344
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License Number State | IL
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