Provider Demographics
NPI:1407411754
Name:VICTORY ENTERPRISES II, INC.
Entity Type:Organization
Organization Name:VICTORY ENTERPRISES II, INC.
Other - Org Name:V2 MEDICAL
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:FREDERIC
Authorized Official - Middle Name:
Authorized Official - Last Name:TALISSE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:847-286-5563
Mailing Address - Street 1:2033 MILWAUKEE AVE # 300
Mailing Address - Street 2:
Mailing Address - City:RIVERWOODS
Mailing Address - State:IL
Mailing Address - Zip Code:60015-3581
Mailing Address - Country:US
Mailing Address - Phone:847-483-8799
Mailing Address - Fax:312-757-4177
Practice Address - Street 1:301 W HINTZ ROAD
Practice Address - Street 2:OFC 008
Practice Address - City:WHEELING
Practice Address - State:IL
Practice Address - Zip Code:60090-5754
Practice Address - Country:US
Practice Address - Phone:847-483-8799
Practice Address - Fax:312-757-4177
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-05-02
Last Update Date:2024-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies