Vista Clinic Corporation

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

Legal business name

VISTA CLINIC CORPORATION

Practice address

1324 N Sheridan Rd
Waukegan, IL 60085-2161

Phone

(847) 360-3000

NPI assigned

Sep 27, 2006

Last updated

Sep 11, 2025By 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

Jack Fahey

Title

Manager

Phone

(847) 360-4065

Specialties & licenses 3

Addresses

Practitioners 6

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Gregory Collins, MD

  • Anesthesiology Physician
  • Maryville, IL
  • NPI 1770654089
  NPD (past)
• Ivailo Dichev Dimov, MD

  • Anesthesiology Physician
  • Highland Park, IL
  • NPI 1578662631
  NPD (past)
• Julia Kogan, MD

  • Internal Medicine Physician
  • Lindenhurst, IL
  • NPI 1790876589
  NPD (past)
• Young Nahm Lee, MD

  • General Practice Physician
  • North Chicago, IL
  • NPI 1699760462
  NPD (past)
• Uzoma Okoli, MD

  • Psychiatry Physician
  • Gurnee, IL
  • NPI 1538168620
  NPD (past)
• Doris K. Walsh, CRNA

  • Registered Nurse
  • Arlington Heights, IL
  • NPI 1407811649
  NPD (past)

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

{
    "created_epoch": "1159315200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1757548800000",
    "number": "1356432215",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1836 LACKLAND HILL PKWY",
            "address_2": "ATTNT: CREDENTIALING DEPARTMENT",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631463572",
            "telephone_number": "314-989-0300",
            "fax_number": "314-810-1399"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1324 N SHERIDAN RD",
            "city": "WAUKEGAN",
            "state": "IL",
            "postal_code": "600852161",
            "telephone_number": "847-360-3000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VISTA CLINIC CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-27",
        "last_updated": "2025-09-11",
        "status": "A",
        "authorized_official_last_name": "FAHEY",
        "authorized_official_first_name": "JACK",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "847-360-4065"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Xochitl Villarreal
• Rebecca Vinson-Boyer, LCPC
• Vireo Emergency Physicians LLC
• Insia Fatema Virji, DMD
• Vision Care Consultants, LTD
• Vista Health (St. Therese Medical Center)
• Vista Health D/B/a St. Therese Medical Center (Star Hospice of Vista Health)
• Vista Health System
• Vista Imaging Associates SC
• Vitalcare Medical SC

• Family Medicine Physician in Waukegan, IL
• Providers in Waukegan, IL by specialty
• Family Medicine Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2025; 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.