| Vivia Health | |
|
3306 W 63rd St Chicago IL 60629-3317 | |
| (773) 273-9604 | |
| (866) 501-5325 |
| Full Name | Vivia Health |
|---|---|
| Speciality | Clinic/Center |
| Location | 3306 W 63rd St, Chicago, Illinois |
| Authorized Official Name and Position | Hina Rehman (CEO) |
| Authorized Official Contact | 7732701652 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Vivia Health 7101 N Cicero Ave Ste 202 Lincolnwood IL 60712-2143 Ph: (312) 863-1040 | Vivia Health 3306 W 63rd St Chicago IL 60629-3317 Ph: (773) 273-9604 |
| NPI Number | 1861086696 |
|---|---|
| Provider Enumeration Date | 02/23/2021 |
| Last Update Date | 10/08/2024 |
| Certification Date | 10/08/2024 |
| Medicare PECOS PAC ID | 8224445762 |
|---|---|
| Medicare Enrollment ID | O20210329001238 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1861086696 | NPI | - | NPPES |
| 20210524417133 | Medicaid | IL |
| Provider Name | Matthew a Brown |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1154324515 PECOS PAC ID: 7012998966 Enrollment ID: I20040526001030 |
| Provider Name | Debra L Conti |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1063621589 PECOS PAC ID: 0941572887 Enrollment ID: I20171130001521 |
| Provider Name | Dorothy Umenze |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1376007922 PECOS PAC ID: 0547696494 Enrollment ID: I20200212001992 |
| Provider Name | David Alexander Ishikawa |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1447731047 PECOS PAC ID: 1153720230 Enrollment ID: I20210521000607 |
| Provider Name | Deborah Aaron |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1114024916 PECOS PAC ID: 6305233024 Enrollment ID: I20220428000314 |
| Provider Name | Jessica Larsen |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1265801096 PECOS PAC ID: 4789060401 Enrollment ID: I20221004002323 |
| Provider Name | Crystal Goods |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1730759614 PECOS PAC ID: 7416353461 Enrollment ID: I20230209002266 |
| Provider Name | Hannah Aderele |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1043907116 PECOS PAC ID: 3678939071 Enrollment ID: I20230509002142 |
| Provider Name | Irena Markova |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1346938362 PECOS PAC ID: 5395199640 Enrollment ID: I20230920003911 |
| Provider Name | Nizar El Khalili |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1861429714 PECOS PAC ID: 9537148101 Enrollment ID: I20240522000450 |
| Provider Name | Ivona Bousheh |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1548097769 PECOS PAC ID: 6103348917 Enrollment ID: I20250321001418 |
| Provider Name | Matthew Braun |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1396535738 PECOS PAC ID: 3173092970 Enrollment ID: I20260520002999 |
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