VMD Primary Providers West Central Florida, PLLC

Organization Active NPI Family Medicine Physician · Chicago, IL

NPI 1093324832 · NPPES record last updated Jul 28, 2020

Key facts

NPI
1093324832
Entity type
Organization (NPI type 2)
Primary specialty
Family Medicine Physician 207Q00000X
Legal business name
VMD PRIMARY PROVIDERS WEST CENTRAL FLORIDA, PLLC
Practice address
125 S Clark St Ste 900
Chicago, IL 60603-4043
Phone
(346) 980-2701
Fax
(713) 932-0437
NPI assigned
Jul 28, 2020
Organization subpart
No

Authorized official

Name
Kristi I Lee, CMPE
Title
Director
Phone
(706) 513-4897

National Provider Directory

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician
Group: 193200000X MULTI-SPECIALTY GROUP
207Q00000X Yes
Internal Medicine Physician
Group: 193200000X MULTI-SPECIALTY GROUP
207R00000X
Physician Assistant
Group: 193200000X MULTI-SPECIALTY GROUP
363A00000X
Nurse Practitioner
Group: 193200000X MULTI-SPECIALTY GROUP
363L00000X

Addresses

Primary practice location

125 S Clark St Ste 900
Chicago, IL 60603-4043

Mailing address

125 S Clark St Ste 900
Chicago, IL 60603-4043
Phone (346) 980-2701

Other providers in Chicago, IL

All providers in Chicago, IL · Family Medicine Physician in Illinois

Sources for this page

Verify at the official NPI Registry.