MEDICARE: VITAL MEASUREMENTS, INC.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	251E00000X	Home Health Agency	1000553	IL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	9692	OTHER	IL	BLUE CROSS BLUE SHIELD

General Provider Information

NPI Number	:	1174682991
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	VITAL MEASUREMENTS, INC.

Provider Business Mailing Address
First Line	:	6323 N AVONDALE AVE STE 250
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60631-1993
Country	:	US
Telephone Number	:	773-467-1777
Fax Number	:	773-467-0022

Provider Business Practice Location Address
First Line	:	6323 N AVONDALE AVE STE 250
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60631-1993
Country	:	US
Telephone Number	:	773-467-1777
Fax Number	:	773-467-0022

Authorized Official
Title or Position	:	ADMINISTRATOR
Name	:	ROMAINE FANNIN
Credential	:	RN.C.
Telephone Number	:	773-467-1777

Provider Enumeration Date	:	12/07/2006
Last Update Date	:	07/22/2010

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Directions to “VITAL MEASUREMENTS, INC. ” Practice Location

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