Provider Demographics
NPI:1760114672
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 BILLING CODING CREDENTIALIN
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 1:3500 LENOX RD NE STE 1500
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30326-4231
Practice Address - Country:US
Practice Address - Phone:312-728-4728
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-06-29
Last Update Date:2024-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty