Vivacious Group Inc.

Primary specialty

Primary Care Clinic/CenterTaxonomy code 261QP2300X

Legal business name

VIVACIOUS GROUP INC.

Practice address

8S165 S Vine St
Burr Ridge, IL 60527-5541

Phone

(630) 835-7613

NPI assigned

Feb 27, 2008

Organization subpart

No

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

Authorized official

Name

Anto Maliakkal, MDNPI 1558376368

Title

President

Phone

(630) 835-7613

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in IN, IL, CA3 enrollments

Enrollment records 3

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Anto Varghese Maliakkal, M.D. H.M.D.C

  • Internal Medicine Physician
  • Burr Ridge, IL
  • NPI 1558376368

  CA, IN

  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1204070400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1685491200000",
    "number": "1275702888",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8S165 S VINE ST",
            "city": "BURR RIDGE",
            "state": "IL",
            "postal_code": "605275541"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8S165 S VINE ST",
            "city": "BURR RIDGE",
            "state": "IL",
            "postal_code": "605275541",
            "telephone_number": "630-835-7613"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VIVACIOUS GROUP INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-02-27",
        "last_updated": "2023-05-31",
        "certification_date": "2023-05-31",
        "status": "A",
        "authorized_official_last_name": "MALIAKKAL",
        "authorized_official_first_name": "ANTO",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "630-835-7613",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Roberto Alfredo Viau Colindres, MD
• Alicia Viera, PSY.D.
• Wickii Vigneswaran, MD
• Minerva Villacrusis, OT
• Ma. Chona Villanueva, PT
• Ronald Volanti Jr., RN, NP
• Vpa PC
• Vpa PC
• Vpa PC
• Linda C Wagner-Weiner, MD

• Primary Care Clinic/Center in Burr Ridge, IL
• Providers in Burr Ridge, IL by specialty
• Primary Care Clinic/Center in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 31, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.