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General NPI Number Information
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NPI Number | 1275022188
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Entity Type | Organization
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Legal Business Name | VIP HEALTH AND FITNESS CLINIC
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Dates
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Enumeration Date | 05/07/2018
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Last Update Date | 05/07/2018
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Provider Practice Location Address
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Address Line | 100 N FAIRWAY DR STE 100-102
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City | VERNON HILLS
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State | IL
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Zip | 60061-1859
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Country | US
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Telephone | 847-971-3611
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Fax |
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Provider Business Mailing Address
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Address Line | 100 N FAIRWAY DR STE 100-102
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City | VERNON HILLS
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State | IL
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Zip | 60061-1859
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Country | US
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Telephone | 847-971-3611
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Fax |
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Authorized Official
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Title or Position | FNP, PROGRAM DIRECTOR
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Name | MS. JANET P. THOMPSON
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Credential | FNP-C
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Telephone | 847-971-3611
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2083P0901X
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Taxonomy Name | Public Health & General Preventive Medicine Physician
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License Number |
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License Number State |
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