Organization
VITAL WELLNESS HEALTHCARE, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
NELIA LAUREL- LADLAD (CEO)
(773) 332-9568
Entity
Organization
Contact information
Practice address
2621 MONTEGA DR STE E, SPRINGFIELD, IL 62704-7002
(312) 989-9260
(773) 345-4637
Mailing address
1717 HOWARD ST, EVANSTON, IL 60202-3735
(773) 332-9568
(773) 345-4637
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
1010318
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1010318
—
IL
Enumeration date
09/05/2018
Last updated
06/11/2019
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