Active NPI
Dolores Ann Vitullo, MD
- Pediatric Cardiology Physician
- Chicago, IL
National Provider Identifier
1639109663
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Cardiology Physician
- License
- 036047742
- Practice address
- 2300 Childrens Plaza Box 21
Childrens Memorial Hospital
Chicago, IL 60614 - Phone
- (773) 880-4553
- Fax
- (773) 880-8111
- NPI assigned
- Jul 4, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatric Cardiology Physician | 2080P0202X | 036047742 | IL | Primary |
Addresses
Primary practice location
2300 Childrens Plaza Box 21
Childrens Memorial Hospital
Chicago, IL 60614
Mailing address
155 Harbor Drive
Unit 1702
Chicago, IL 60601
Phone (312) 856-0980
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 036047742 | Medicaid | IL |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1151971200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1187049600000",
"number": "1639109663",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "155 HARBOR DRIVE",
"address_2": "UNIT 1702",
"city": "CHICAGO",
"state": "IL",
"postal_code": "60601",
"telephone_number": "312-856-0980"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2300 CHILDRENS PLAZA BOX 21",
"address_2": "CHILDRENS MEMORIAL HOSPITAL",
"city": "CHICAGO",
"state": "IL",
"postal_code": "60614",
"telephone_number": "773-880-4553",
"fax_number": "773-880-8111"
}
],
"practiceLocations": [],
"basic": {
"last_name": "VITULLO",
"first_name": "DOLORES",
"middle_name": "ANN",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-07-04",
"last_updated": "2007-08-14",
"status": "A"
},
"taxonomies": [
{
"code": "2080P0202X",
"taxonomy_group": "",
"desc": "Pediatrics, Pediatric Cardiology",
"state": "IL",
"license": "036047742",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "036047742",
"state": "IL"
}
],
"endpoints": [],
"other_names": []
}Other providers in Chicago, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 14, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.