Organization Active NPI

Vitae Health Medical Missouri LLC

  • Internal Medicine Physician
  • Saint Louis, MO
National Provider Identifier
1720726748
Registry record updated Mar 25, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
Legal business name
VITAE HEALTH MEDICAL MISSOURI LLC
Practice address
3625 Magnolia Ave
Saint Louis, MO 63110-4048
Phone
(314) 771-2990
NPI assigned
May 20, 2022
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 25, 2025

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

Authorized official

Name
Yitzchak Freund
Title
Chief Operating Officer
Phone
(224) 777-8045

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social WorkerGroup: 193200000X MULTI-SPECIALTY GROUP 1041C0700X
Internal Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207R00000X Primary

Addresses

Primary practice location

3625 Magnolia Ave
Saint Louis, MO 63110-4048

Mailing address

415 W Golf Rd Ste 26
Arlington Heights, IL 60005-3923
Phone (224) 777-8034

National Provider Directory

National Provider Directory

Locations

3625 Magnolia Ave
#H
Saint Louis, MO 63110
Phone (314) 771-2990

Practitioners & affiliated clinicians

Practitioners 1

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

NPI Registry JSON

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

{
    "created_epoch": "1653004800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1742860800000",
    "number": "1720726748",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "415 W GOLF RD STE 26",
            "city": "ARLINGTON HEIGHTS",
            "state": "IL",
            "postal_code": "600053923",
            "telephone_number": "224-777-8034"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3625 MAGNOLIA AVE",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631104048",
            "telephone_number": "314-771-2990"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VITAE HEALTH MEDICAL MISSOURI LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-05-20",
        "last_updated": "2025-03-25",
        "certification_date": "2025-03-25",
        "status": "A",
        "authorized_official_last_name": "FREUND",
        "authorized_official_first_name": "YITZCHAK",
        "authorized_official_title_or_position": "CHIEF OPERATING OFFICER",
        "authorized_official_telephone_number": "224-777-8045"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Louis, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 25, 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.