Vida Medical Centers PLLC

Primary specialty

General Practice PhysicianTaxonomy code 208D00000X

Legal business name

VIDA MEDICAL CENTERS PLLC

Practice address

8101 S Cicero Ave
Chicago, IL 60652-2017

Phone

(773) 610-8505

NPI assigned

Feb 20, 2023

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Jose Carlo Martinez, DC

Title

Authorized Official

Phone

(815) 258-2115

Specialties & licenses 1

Addresses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1676851200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1681776000000",
    "number": "1093413049",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8101 S CICERO AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606522017",
            "telephone_number": "773-610-8505"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8101 S CICERO AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606522017",
            "telephone_number": "773-610-8505"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2615 E Cass St",
            "address_purpose": "LOCATION",
            "city": "Joliet",
            "state": "IL",
            "postal_code": "604329761",
            "country_code": "US",
            "telephone_number": "815-258-2115",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "VIDA MEDICAL CENTERS PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-02-20",
        "last_updated": "2023-04-18",
        "certification_date": "2023-04-18",
        "status": "A",
        "authorized_official_last_name": "MARTINEZ",
        "authorized_official_first_name": "JOSE",
        "authorized_official_middle_name": "CARLO",
        "authorized_official_title_or_position": "AUTHORIZED OFFICIAL",
        "authorized_official_telephone_number": "815-258-2115",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Victory Medical Supply Inc
• Victory Pharmacy of Decatur Inc
• Victory Place
• Victory RX, Inc
• Vida Health Wellness, PLLC
• Vida Pediatrics, LTD.
• Vida Therapy
• Gabriel Ernest Vida, DDS
• Vidal Therapy PLLC
• Annabella Vidal-Ruiz, PMHNP

• General Practice Physician in Chicago, IL
• Providers in Chicago, IL by specialty
• General Practice Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 18, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.