| Vital Family Healthcare Llc. | |
|
1004 Logan Ave Belvidere IL 61008 | |
| (815) 482-6365 | |
| Not Available |
| Full Name | Vital Family Healthcare Llc. |
|---|---|
| Speciality | Clinic/Center |
| Location | 1004 Logan Ave, Belvidere, Illinois |
| Authorized Official Name and Position | Jaclyn Newhart (MANAGER) |
| Authorized Official Contact | 8154826365 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Vital Family Healthcare Llc. 1004 Logan Ave Belvidere IL 61008-3955 Ph: (815) 482-6365 | Vital Family Healthcare Llc. 1004 Logan Ave Belvidere IL 61008 Ph: (815) 482-6365 |
| NPI Number | 1417647066 |
|---|---|
| Provider Enumeration Date | 05/08/2023 |
| Last Update Date | 04/12/2026 |
| Medicare PECOS PAC ID | 8729434279 |
|---|---|
| Medicare Enrollment ID | O20231019003119 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1417647066 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | (* (Not Available)) | Primary |
| 363L00000X | Nurse Practitioner | (* (Not Available)) | Secondary |
| Provider Name | Ferdinand Catotal |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1538681572 PECOS PAC ID: 5799015350 Enrollment ID: I20230329002088 |
| Provider Name | Eileen A Solis |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1699277038 PECOS PAC ID: 3173979622 Enrollment ID: I20231019003169 |
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Shobha S Iyengar, Md Sc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 2186 Unit 1, North State Street, Belvidere, IL 61008 Phone: 815-547-5007 | |
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