MEDICARE: VITAL PRODUCTS, 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	332B00000X	Durable Medical Equipment & Medical Supplies

General Provider Information

NPI Number	:	1275520553
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	VITAL PRODUCTS, INC

Provider Business Mailing Address
First Line	:	4332 N CALIFORNIA AVE
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60618-1514
Country	:	US
Telephone Number	:	773-463-4455
Fax Number	:	773-463-5099

Provider Business Practice Location Address
First Line	:	4332 N CALIFORNIA AVE
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60618-1514
Country	:	US
Telephone Number	:	773-463-4455
Fax Number	:	773-463-5099

Authorized Official
Title or Position	:	MANAGER
Name	:	RICK L COCKING
Credential	:
Telephone Number	:	773-463-4455

Provider Enumeration Date	:	10/03/2005
Last Update Date	:	08/11/2015

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Directions to “VITAL PRODUCTS, INC ” Practice Location

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