Individual provider Active NPI

Joseph J. Vitez

  • Nuclear Medicine Technology Radiologic Technologist
  • Bellwood, IL
National Provider Identifier
1174855290
Registry record updated Feb 1, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nuclear Medicine Technology Radiologic TechnologistTaxonomy code 2471N0900X
License
500493344 Issued in IL
Practice address
2615 Harrison St
Bellwood, IL 60104-2450
Phone
(708) 493-0199
Fax
(708) 493-9683
NPI assigned
Feb 1, 2010
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 1, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nuclear Medicine Technology Radiologic Technologist 2471N0900X 500493344 IL Primary

Addresses

Primary practice location

2615 Harrison St
Bellwood, IL 60104-2450

Mailing address

2615 Harrison St
Bellwood, IL 60104-2450
Phone (708) 493-0199

Other identifiers 1

IdentifierTypeStateIssuer
500493344OtherILLICENSE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
500493344ILMDNuclear Medicine Technology Radiologic Technologist

NPI Registry JSON

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

{
    "created_epoch": "1264982400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1264982400000",
    "number": "1174855290",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2615 HARRISON ST",
            "city": "BELLWOOD",
            "state": "IL",
            "postal_code": "601042450",
            "telephone_number": "708-493-0199",
            "fax_number": "708-493-9683"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2615 HARRISON ST",
            "city": "BELLWOOD",
            "state": "IL",
            "postal_code": "601042450",
            "telephone_number": "708-493-0199",
            "fax_number": "708-493-9683"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VITEZ",
        "first_name": "JOSEPH",
        "middle_name": "J.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-02-01",
        "last_updated": "2010-02-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2471N0900X",
            "taxonomy_group": "",
            "desc": "Radiologic Technologist, Nuclear Medicine Technology",
            "state": "IL",
            "license": "500493344",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "500493344",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bellwood, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 1, 2010; 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.