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General NPI Number Information
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NPI Number | 1982654091
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Entity Type | Organization
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Legal Business Name | VIVENT HEALTH INC
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Dates
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Enumeration Date | 05/11/2006
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Last Update Date | 05/08/2025
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Provider Practice Location Address
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Address Line | 1311 N 6TH ST
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City | MILWAUKEE
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State | WI
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Zip | 53212-4006
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Country | US
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Telephone | 866-525-5484
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 18412
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City | PALATINE
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State | IL
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Zip | 60055-8412
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Country | US
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Telephone | 866-525-5484
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Fax | 414-225-1575
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Authorized Official
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Title or Position | SR. DIRECTOR OF CORPORATE SERVICES
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Name | MR. JOANN BERK
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Credential |
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Telephone | 414-225-1568
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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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 | 261QH0100X
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Taxonomy Name | Health Service Clinic/Center
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License Number |
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License Number State |
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Taxonomy #3
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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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