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General NPI Number Information
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NPI Number | 1811818412
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Entity Type | Organization
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Legal Business Name | VITAL CORE PHYSICAL THERAPY AND WELLNESS LLC
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Dates
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Enumeration Date | 07/22/2026
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Last Update Date | 07/22/2026
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Provider Practice Location Address
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Address Line | 409 W HURON ST STE 300
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City | CHICAGO
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State | IL
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Zip | 60654-3431
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Country | US
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Telephone | 708-288-5212
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Fax |
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Provider Business Mailing Address
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Address Line | 1758 W 18TH PL UNIT 1F
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City | CHICAGO
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State | IL
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Zip | 60608-4427
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Country | US
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Telephone | 708-288-5212
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | CYNTHIA COVIAN-HERNANDEZ
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Credential | PT
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Telephone | 708-288-5212
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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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