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General NPI Number Information
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NPI Number | 1679311336
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Entity Type | Organization
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Legal Business Name | VITAL LINK PHYSICIAN GROUP PLLC
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Dates
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Enumeration Date | 07/17/2024
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Last Update Date | 07/08/2025
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Provider Practice Location Address
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Address Line | 6201 W HOWARD ST
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City | NILES
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State | IL
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Zip | 60714-3436
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Country | US
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Telephone | 847-774-7316
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Fax |
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Provider Business Mailing Address
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Address Line | 6201 W HOWARD ST
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City | NILES
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State | IL
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Zip | 60714-3436
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | MANAGEMENT
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Name | EMANUEL ATKIN
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Credential |
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Telephone | 212-734-6621
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 171M00000X
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Taxonomy Name | Case Manager/Care Coordinator
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number |
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License Number State |
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