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Organization
VITALISCARE CLINIC LLC
Active
Organization
VITALISCARE CLINIC LLC
Active
Other names
MKBB LLC
Organization subpart
No
Provider details
NPI number
Authorized official
MARIA KORDAS APN (DIRECTOR)
(224) 713-0003
Entity
Organization
Contact information
Practice address
1212 E ALGONQUIN RD, ALGONQUIN, IL 60102-5446
(224) 713-0003
(224) 678-7122
Mailing address
1212 E ALGONQUIN RD, ALGONQUIN, IL 60102-5446
(224) 713-0003
(224) 678-7122
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
—
NULL
363LA2200X
Adult Health Nurse Practitioner
Primary
—
—
Other
Enumeration date
09/25/2019
Last updated
04/19/2021
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