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General NPI Number Information
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NPI Number | 1255718094
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Entity Type | Organization
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Legal Business Name | VITA NOVA PLLC
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Dates
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Enumeration Date | 04/30/2015
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Last Update Date | 10/15/2024
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Provider Practice Location Address
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Address Line | 307 N MICHIGAN AVE STE 1014
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City | CHICAGO
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State | IL
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Zip | 60601-5310
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Country | US
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Telephone | 773-234-3258
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Fax |
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Provider Business Mailing Address
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Address Line | 307 N MICHIGAN AVE STE 1014
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City | CHICAGO
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State | IL
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Zip | 60601-5310
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Country | US
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Telephone | 773-234-3258
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Fax |
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Authorized Official
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Title or Position | MANAGER
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Name | DR. FRANCESCO BELVISO
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Credential |
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Telephone | 773-234-3258
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | 071008461
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License Number State | IL
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