Provider Demographics
NPI:1710764477
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 1:6991 E CAMELBACK RD # 300
Practice Address - Street 2:
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85251-2432
Practice Address - Country:US
Practice Address - Phone:408-518-2712
Practice Address - Fax:630-566-8294
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:VIRTUMED LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2023-09-14
Last Update Date:2023-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationGroup - Multi-Specialty