Provider Demographics
NPI:1801992938
Name:VITAL HOME & HEALTHCARE, INC
Entity type:Organization
Organization Name:VITAL HOME & HEALTHCARE, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:ASIF
Authorized Official - Middle Name:A
Authorized Official - Last Name:SAYEED
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:708-342-7076
Mailing Address - Street 1:8051 186TH ST
Mailing Address - Street 2:SUITE A
Mailing Address - City:TINLEY PARK
Mailing Address - State:IL
Mailing Address - Zip Code:60477-9341
Mailing Address - Country:US
Mailing Address - Phone:708-342-7076
Mailing Address - Fax:708-342-7083
Practice Address - Street 1:8051 186TH ST
Practice Address - Street 2:SUITE A
Practice Address - City:TINLEY PARK
Practice Address - State:IL
Practice Address - Zip Code:60477-9341
Practice Address - Country:US
Practice Address - Phone:708-342-7076
Practice Address - Fax:708-342-7083
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-16
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN002870251E00000X
IL1007087251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL9953OtherBLUECROSSBLUESHIELD
IL=========001Medicaid
147602Medicare ID - Type Unspecified