| Vistalink Health Group, Llc | |
|
2549 Waukegan Rd Ste 531 Bannockburn IL 60015-1569 | |
| (847) 951-1277 | |
| Not Available |
| Full Name | Vistalink Health Group, Llc |
|---|---|
| Speciality | Internal Medicine |
| Location | 2549 Waukegan Rd Ste 531, Bannockburn, Illinois |
| Authorized Official Name and Position | David Fleming (CEO) |
| Authorized Official Contact | 8479511277 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Vistalink Health Group, Llc 2549 Waukegan Rd Ste 531 Bannockburn IL 60015-1569 Ph: (847) 951-1277 | Vistalink Health Group, Llc 2549 Waukegan Rd Ste 531 Bannockburn IL 60015-1569 Ph: (847) 951-1277 |
| NPI Number | 1447872676 |
|---|---|
| Provider Enumeration Date | 05/11/2020 |
| Last Update Date | 10/15/2020 |
| Medicare PECOS PAC ID | 6406273085 |
|---|---|
| Medicare Enrollment ID | O20200827001333 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1447872676 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | (* (Not Available)) | Primary |
| 305S00000X | Point Of Service | (* (Not Available)) | Secondary |
| Provider Name | Johnnie Lewis |
|---|---|
| Provider Type | Practitioner - Podiatry |
| Provider Identifiers | NPI Number: 1013998194 PECOS PAC ID: 2062574841 Enrollment ID: I20090105000231 |
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