Vitaliscare Clinic LLC

Primary specialty

Adult Health Nurse PractitionerTaxonomy code 363LA2200X

Legal business name

VITALISCARE CLINIC LLC

Practice address

1212 E Algonquin Rd
Algonquin, IL 60102-5446

Phone

(224) 713-0003

Fax

(224) 678-7122

NPI assigned

Sep 25, 2019

Last updated

Apr 19, 2021By 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

Maria Kordas, APNNPI 1639534381

Title

Director

Phone

(224) 713-0003

Specialties & licenses 1

Addresses

Other names 1

• MKBB LLC Other name

Electronic endpoints 1

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, and the practitioner matching its NPPES authorized official.

• Maria Kordas

  • Gerontology Nurse Practitioner
  • Algonquin, IL
  • NPI 1639534381
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1569369600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1618790400000",
    "number": "1881245314",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1212 E ALGONQUIN RD",
            "city": "ALGONQUIN",
            "state": "IL",
            "postal_code": "601025446",
            "telephone_number": "224-713-0003",
            "fax_number": "224-678-7122"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1212 E ALGONQUIN RD",
            "city": "ALGONQUIN",
            "state": "IL",
            "postal_code": "601025446",
            "telephone_number": "224-713-0003",
            "fax_number": "224-678-7122"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VITALISCARE CLINIC LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-09-25",
        "last_updated": "2021-04-19",
        "certification_date": "2021-04-19",
        "status": "A",
        "authorized_official_last_name": "KORDAS",
        "authorized_official_first_name": "MARIA",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "224-713-0003",
        "authorized_official_credential": "APN"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mk@vitaliscareclinic.com",
            "affiliation": "N",
            "endpointDescription": "buissness email",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "health info",
            "address_1": "1212 E Algonquin Rd",
            "city": "Algonquin",
            "state": "IL",
            "country_code": "US",
            "postal_code": "601025446",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "MKBB LLC",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Daniel Robert Valeria, D.C.
• Alyssa Valiga
• Allie N Van Dril, DPT
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• Vigeo Care Center PLLC
• Vitality Counseling
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• Tomasz Wala, PT
• Walgreen Co (Walgreens #09059)
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• Adult Health Nurse Practitioner in Algonquin, IL
• Providers in Algonquin, IL by specialty
• Adult Health Nurse Practitioner in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 19, 2021; 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.