Provider Demographics
NPI:1235821943
Name:VIRTUMED LLC
Entity Type:Organization
Organization Name:VIRTUMED LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:RIZWAN
Authorized Official - Middle Name:
Authorized Official - Last Name:KHAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:408-518-2712
Mailing Address - Street 1:9400 W HIGGINS RD STE 210
Mailing Address - Street 2:
Mailing Address - City:ROSEMONT
Mailing Address - State:IL
Mailing Address - Zip Code:60018-4975
Mailing Address - Country:US
Mailing Address - Phone:408-518-2712
Mailing Address - Fax:630-566-8294
Practice Address - Street 1:1616 GATEWAY BLVD
Practice Address - Street 2:
Practice Address - City:RICHARDSON
Practice Address - State:TX
Practice Address - Zip Code:75080-3529
Practice Address - Country:US
Practice Address - Phone:408-518-2712
Practice Address - Fax:630-566-8294
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-05-22
Last Update Date:2024-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationGroup - Multi-Specialty