Organization
VWELL WEST, INC.
Active
Parent organization
VITAL WELLNESS HOME HEALTH, INC.
Other names
Vital Wellness
Organization subpart
Yes
Provider details
NPI number
Legal business name
VITAL WELLNESS HOME HEALTH, INC.
Authorized official
MR. ALLAN DENNIS ROSALES (CLINICAL OPERATIONS EXECUTIVE)
(312) 989-9260
Entity
Organization
Contact information
Practice address
1601 BOND ST, SUITE 210, NAPERVILLE, IL 60563
(888) 258-9355
(630) 369-6984
Mailing address
1717 HOWARD ST, EVANSTON, IL 60202-3735
(888) 258-9355
(630) 369-6984
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
HHA4404
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
147806
MEDICARE PROVIDER NUMBER
IL
Enumeration date
07/15/2008
Last updated
08/29/2018
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