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Individual

DANIEL W VITTUM

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
1800 HARLEM AVE STE A, NORTH RIVERSIDE, IL 60546-1468
(708) 783-9800
(773) 780-9810
Mailing address
1800 HARLEM AVE STE A, NORTH RIVERSIDE, IL 60546-1468
(708) 783-9800
(708) 783-9810

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
036104765
IL

Other

Enumeration date
10/05/2006
Last updated
05/04/2021
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