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Organization

VITA NOBLESSE INC.

Active
Organization subpart
No

Provider details

NPI number
Authorized official
D'LOREYN WALKER M.D. (PRESIDENT/OWNER)
(708) 941-1174
Entity
Organization

Contact information

Practice address
6006 W. 159TH ST, BLDG A, STE 2B/WEST, OAK FOREST, IL 60452-2904
(708) 941-1174
Mailing address
6006 W. 159TH ST, BLDG A, STE 2B/WEST, OAK FOREST, IL 60452-2904
(708) 941-1174

Taxonomy

Speciality
Code
Description
License number
State
261QM0850X
Adult Mental Health Clinic/Center
036.126980
IL
261QM0855X
Adolescent and Children Mental Health Clinic/Center
Primary
036.126980
IL

Other

Enumeration date
03/12/2012
Last updated
03/12/2012
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