MEDICARE: VSH HEALTH LLC

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	363LF0000X	Family Nurse Practitioner

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1841794237
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	VSH HEALTH LLC

Provider Business Mailing Address
First Line	:	19710 GOVERNORS HWY STE 1
Second Line	:
City	:	FLOSSMOOR
State	:	IL
Zip	:	60422-2081
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	19710 GOVERNORS HWY STE 1
Second Line	:
City	:	FLOSSMOOR
State	:	IL
Zip	:	60422-2081
Country	:	US
Telephone Number	:	708-888-2231
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	VELISCIA HODGES
Credential	:	APN, FNP-C
Telephone Number	:	708-785-0178

Provider Enumeration Date	:	03/20/2018
Last Update Date	:	05/29/2019

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