Provider Demographics
NPI:1356074173
Name:VIP 2U, LTD.
Entity Type:Organization
Organization Name:VIP 2U, LTD.
Other - Org Name:ALC PRIMARY CARE AT HOME
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:JENNIFER
Authorized Official - Middle Name:
Authorized Official - Last Name:ZAMORA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:312-728-4728
Mailing Address - Street 1:360 W BUTTERFIELD RD STE 325
Mailing Address - Street 2:
Mailing Address - City:ELMHURST
Mailing Address - State:IL
Mailing Address - Zip Code:60126-5088
Mailing Address - Country:US
Mailing Address - Phone:312-728-4728
Mailing Address - Fax:312-728-4729
Practice Address - Street 1:200 W MARTIN LUTHER KING BLVD STE 1000
Practice Address - Street 2:
Practice Address - City:CHATTANOOGA
Practice Address - State:TN
Practice Address - Zip Code:37402-2571
Practice Address - Country:US
Practice Address - Phone:423-521-5404
Practice Address - Fax:423-425-9939
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-07-08
Last Update Date:2024-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RG0300XAllopathic & Osteopathic PhysiciansInternal MedicineGeriatric MedicineGroup - Multi-Specialty