Active NPI
Vitality Family Medical & Wellness PLLC
- Family Nurse Practitioner
- Bourbonnais, IL
National Provider Identifier
1902775984
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Nurse Practitioner
- Legal business name
- VITALITY FAMILY MEDICAL & WELLNESS PLLC
- Practice address
- 232 Main St NW Ste 203
Bourbonnais, IL 60914-2186 - Phone
- (815) 954-0136
- NPI assigned
- Oct 30, 2025
- Last updated
- Jan 21, 2026
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Karen N Smartt
- Title
- Ao
- Phone
- (717) 504-3090
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | Primary |
Addresses
Primary practice location
232 Main St NW Ste 203
Bourbonnais, IL 60914-2186
Mailing address
232 Main St NW Ste 203
Bourbonnais, IL 60914-2186
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in IL
Enrollment records 1
Laboratory certificates & supplier records
Derived by NPIMapThese CMS records do not include an NPI. They are shown because their name and street address match this provider’s.
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 14D2336393 | Vitality Family Medicine & Wellness PLLC | Certificate of waiver | Jan 1, 2028 |
National Provider Directory
National Provider DirectoryLocations
232 Main St NW
Ste 203
Bourbonnais, IL 60914
Phone (815) 954-0136
Practitioners & affiliated clinicians
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.
-
- Family Nurse Practitioner
- Bourbonnais, IL
- NPI 1396293593
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1761782400000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1768953600000",
"number": "1902775984",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "232 MAIN ST NW STE 203",
"city": "BOURBONNAIS",
"state": "IL",
"postal_code": "609142186"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "232 MAIN ST NW STE 203",
"city": "BOURBONNAIS",
"state": "IL",
"postal_code": "609142186",
"telephone_number": "815-954-0136"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "VITALITY FAMILY MEDICAL & WELLNESS PLLC",
"organizational_subpart": "NO",
"enumeration_date": "2025-10-30",
"last_updated": "2026-01-21",
"certification_date": "2026-01-21",
"status": "A",
"authorized_official_last_name": "SMARTT",
"authorized_official_first_name": "KAREN",
"authorized_official_middle_name": "N",
"authorized_official_title_or_position": "AO",
"authorized_official_telephone_number": "717-504-3090"
},
"taxonomies": [
{
"code": "363LF0000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Nurse Practitioner, Family",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Bourbonnais, IL
- Mark Vidas, O.D.
- Edwin Viglia III, LPC
- Joel P Villegas, MD
- Vishwam, Inc (Bourbonnais Pharmacy)
- Vishwam, Inc (Bourbonnais Pharmacy)
- Vna Home Health of Illinois LTD (VNA Healthtrends South)
- Suresh H Wadhwani, M.D. S.C.
- Frederick P Waldschmidt, D.D.S.
- Walgreen Co (Walgreens #10339)
- Walgreen Co. (Walgreens #10339)
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 21, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.