# CENTER FOR VEIN RESTORATION IL LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1790653871
- **Authorized official:** LORENA THOMAS (CRED MANAGER)
- **Authorized official phone:** (815) 254-1761

## Contact information

- **Practice address:** 10755 W 143RD ST, ORLAND PARK, IL 60462-1900
- **Practice address phone:** (855) 830-8346
- **Mailing address:** 7474 GREENWAY CENTER DR STE 1000, GREENBELT, MD 20770-3500
- **Mailing address phone:** (855) 830-8346

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 208G00000X | Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician | — | NULL | Yes |
| 208G00000X | Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician | — | — | Yes |

## Other

- **Enumeration date:** 10/29/2025
- **Last updated:** 10/29/2025