Provider Demographics
NPI:1265802714
Name:JAMES M VELTMAN VINEKEEPERS PC
Entity type:Organization
Organization Name:JAMES M VELTMAN VINEKEEPERS PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PSYCHOTHERAPIST/PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:M
Authorized Official - Last Name:VELTMAN
Authorized Official - Suffix:
Authorized Official - Credentials:LCPC
Authorized Official - Phone:224-612-2031
Mailing Address - Street 1:100 N. ATKINSON ROAD
Mailing Address - Street 2:SUITE 112-F
Mailing Address - City:GRAYSLAKE
Mailing Address - State:IL
Mailing Address - Zip Code:60030-7805
Mailing Address - Country:US
Mailing Address - Phone:224-612-2031
Mailing Address - Fax:
Practice Address - Street 1:100 N. ATKINSON ROAD
Practice Address - Street 2:SUITE 112-F
Practice Address - City:GRAYSLAKE
Practice Address - State:IL
Practice Address - Zip Code:60030-7805
Practice Address - Country:US
Practice Address - Phone:224-612-2031
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-09-28
Last Update Date:2015-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL180.000497251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health