Provider Demographics
NPI:1174682991
Name:VITAL MEASUREMENTS, INC.
Entity Type:Organization
Organization Name:VITAL MEASUREMENTS, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:ROMAINE
Authorized Official - Middle Name:
Authorized Official - Last Name:FANNIN
Authorized Official - Suffix:
Authorized Official - Credentials:RNC
Authorized Official - Phone:773-467-1777
Mailing Address - Street 1:6323 N AVONDALE AVE STE 250
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60631-1993
Mailing Address - Country:US
Mailing Address - Phone:773-467-1777
Mailing Address - Fax:773-467-0022
Practice Address - Street 1:6323 N AVONDALE AVE STE 250
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60631-1993
Practice Address - Country:US
Practice Address - Phone:773-467-1777
Practice Address - Fax:773-467-0022
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-07
Last Update Date:2010-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL1000553251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL9692OtherBLUE CROSS BLUE SHIELD
IL9692OtherBLUE CROSS BLUE SHIELD
IL=========001Medicaid