Organization
VITAL MEDICAL NETWORK
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. ED BAUER (PARTNER)
(312) 560-6151
Entity
Organization
Contact information
Practice address
17 W GRAND AVE, CHICAGO, IL 60654-4844
(312) 462-4081
(312) 276-4064
Mailing address
PO BOX 734116, CHICAGO, IL 60673-4116
(312) 462-4081
(312) 276-4064
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
203.002039
DME LICENSE
IL
Enumeration date
03/08/2019
Last updated
11/09/2023
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