Vital Labs Inc

Primary specialty

Clinical Medical LaboratoryTaxonomy code 291U00000X

Legal business name

VITAL LABS INC

Practice address

4176 W Montrose Ave
Chicago, IL 60641-2161

Phone

(773) 654-3069

NPI assigned

Sep 21, 2020

Organization subpart

No

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

Authorized official

Name

Fakhra Shafi

Title

Managing Director

Phone

(773) 654-3069

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1600646400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1602460800000",
    "number": "1487260923",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4176 W MONTROSE AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606412161",
            "telephone_number": "773-654-3069"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4176 W MONTROSE AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606412161",
            "telephone_number": "773-654-3069"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VITAL LABS INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-09-21",
        "last_updated": "2020-10-12",
        "certification_date": "2020-10-12",
        "status": "A",
        "authorized_official_last_name": "SHAFI",
        "authorized_official_first_name": "FAKHRA",
        "authorized_official_title_or_position": "MANAGING DIRECTOR",
        "authorized_official_telephone_number": "773-654-3069"
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Vital Care Home Health, Inc
• Vital Core Physical Therapy and Wellness LLC
• Vital Flow Vitality LLC
• Vital Health Integrative Chiropractic Center
• Vital Healthcare, LLC.
• Vital Measurements, Inc.
• Vital Medical Network
• Vital Medical Supplies Inc
• Vital Products, Inc
• Vital Rehabilitation

• Clinical Medical Laboratory in Chicago, IL
• Providers in Chicago, IL by specialty
• Clinical Medical Laboratory in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 12, 2020; 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.