Institute for Vein Health LLC

Primary specialty

Phlebology PhysicianTaxonomy code 202K00000X

License

036111722 Issued in IL

Legal business name

INSTITUTE FOR VEIN HEALTH LLC

Practice address

1450 W Lake St Ste 101
Addison, IL 60101-5768

Phone

(630) 401-7102

Fax

(630) 566-6879

NPI assigned

Jan 3, 2017

Organization subpart

No

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

Authorized official

Name

Peter Brukasz, MDNPI 1396728978

Title

Owner

Phone

(630) 401-7102

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in IL

Enrollment records 1

Practitioners 1

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

• Peter Brukasz, M.D.

  • Phlebology Physician
  • Palos Hills, IL
  • NPI 1396728978
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1483401600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1672963200000",
    "number": "1619412574",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1450 W LAKE ST STE 101",
            "city": "ADDISON",
            "state": "IL",
            "postal_code": "601015768",
            "telephone_number": "630-401-7102",
            "fax_number": "630-566-6879"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1450 W LAKE ST STE 101",
            "city": "ADDISON",
            "state": "IL",
            "postal_code": "601015768",
            "telephone_number": "630-401-7102",
            "fax_number": "630-566-6879"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INSTITUTE FOR VEIN HEALTH LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-01-03",
        "last_updated": "2023-01-06",
        "certification_date": "2023-01-06",
        "status": "A",
        "authorized_official_last_name": "BRUKASZ",
        "authorized_official_first_name": "PETER",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "630-401-7102",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "202K00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Phlebology",
            "state": "IL",
            "license": "036111722",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jerry A Iavarone, D.C.
• Maricela Ibarra
• Gail Ihnen, LCP
• Michael Illes
• Linda Kay Impastato
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• Anna Marie Ippolito
• Eliza Jacob
• Egill Lars Jacobsen, DDS
• Jain Pediatrics LLC

• Phlebology Physician in Addison, IL
• Providers in Addison, IL by specialty
• Phlebology Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 6, 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.