Vhab Llc | |
405 N Waloosh Ave, Apt 1203, Chicago, IL 60611 | |
(312) 586-7574 | |
Not Available |
Full Name | Vhab Llc |
---|---|
Type | Facility |
Speciality | Physical Therapist |
Location | 405 N Waloosh Ave, Chicago, Illinois |
Accepts Medicare Assignments | Medicare enrolled and accepts medicare insurance. Providers at this facility may prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1043804982 | NPI | - | NPPES |
12202684 | Other | IL | CAQH |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
225100000X | Physical Therapist | (* (Not Available)) | Primary |
Provider Name | Vanessa R Martin |
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Provider Type | Practitioner - Physical Therapist In Private Practice |
Provider Identifiers | NPI Number: 1801062740 PECOS PAC ID: 3375611106 Enrollment ID: I20180425000599 |
Mailing Address | Practice Location Address |
---|---|
Vhab Llc 405 North Mabash Avenue, 1203, Chicago, IL 60611 Ph: (702) 281-2815 | Vhab Llc 405 N Waloosh Ave, Apt 1203, Chicago, IL 60611 Ph: (312) 586-7574 |
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