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General NPI Number Information
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NPI Number | 1275157976
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Entity Type | Organization
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Legal Business Name | VELONA HEALTH PLLC
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Dates
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Enumeration Date | 05/29/2020
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Last Update Date | 05/29/2020
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Provider Practice Location Address
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Address Line | 1525 E 53RD ST STE 627
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City | CHICAGO
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State | IL
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Zip | 60615-4575
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Country | US
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Telephone | 312-324-0953
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Fax | 312-324-0958
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Provider Business Mailing Address
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Address Line | 1525 E 53RD ST STE 627
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City | CHICAGO
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State | IL
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Zip | 60615-4575
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Country | US
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Telephone | 312-324-0953
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Fax | 312-324-0958
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Authorized Official
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Title or Position | OWNER AND FOUNDER
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Name | CJ MIMEE
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Credential |
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Telephone | 312-324-0953
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number |
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License Number State |
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