Vita Noblesse Inc.

Primary specialty

Adolescent and Children Mental Health Clinic/CenterTaxonomy code 261QM0855X

License

036.126980 Issued in IL

Legal business name

VITA NOBLESSE INC.

Practice address

6006 W. 159TH St
BLDG a, Ste 2B/West
Oak Forest, IL 60452-2904

Phone

(708) 941-1174

NPI assigned

Mar 12, 2012

Last updated

Mar 12, 2012By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

D'Loreyn Walker, M.D.

Title

President/Owner

Phone

(708) 941-1174

Specialties & licenses 2

Addresses

Locations

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

{
    "created_epoch": "1331510400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1331510400000",
    "number": "1346515244",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6006 W. 159TH ST",
            "address_2": "BLDG A, STE 2B/WEST",
            "city": "OAK FOREST",
            "state": "IL",
            "postal_code": "604522904",
            "telephone_number": "708-941-1174"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6006 W. 159TH ST",
            "address_2": "BLDG A, STE 2B/WEST",
            "city": "OAK FOREST",
            "state": "IL",
            "postal_code": "604522904",
            "telephone_number": "708-941-1174"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VITA NOBLESSE INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-03-12",
        "last_updated": "2012-03-12",
        "status": "A",
        "authorized_official_last_name": "WALKER",
        "authorized_official_first_name": "D'LOREYN",
        "authorized_official_title_or_position": "PRESIDENT/OWNER",
        "authorized_official_telephone_number": "708-941-1174",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "261QM0850X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Mental Health",
            "state": "IL",
            "license": "036.126980",
            "primary": false
        },
        {
            "code": "261QM0855X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adolescent and Children Mental Health",
            "state": "IL",
            "license": "036.126980",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Adolescent and Children Mental Health Clinic/Center in Oak Forest, IL
• Providers in Oak Forest, IL by specialty
• Adolescent and Children Mental Health Clinic/Center in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 12, 2012; 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.