Organization
VIVACIOUS GROUP INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ANTO MALIAKKAL MD (PRESIDENT)
(630) 835-7613
Entity
Organization
Contact information
Practice address
8S165 S VINE ST, BURR RIDGE, IL 60527-5541
(630) 835-7613
Mailing address
8S165 S VINE ST, BURR RIDGE, IL 60527-5541
Taxonomy
Speciality
Code
Description
License number
State
261QP2300X
Primary Care Clinic/Center
Primary
—
IL
Other
Enumeration date
02/27/2008
Last updated
05/31/2023
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