Provider Demographics
NPI:1689182859
Name:VIOS FERTILITY INSTITUTE CHICAGO
Entity type:Organization
Organization Name:VIOS FERTILITY INSTITUTE CHICAGO
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:DIRECTOF OF INSURANCE CREDENTIALING
Authorized Official - Prefix:
Authorized Official - First Name:KATRINA
Authorized Official - Middle Name:
Authorized Official - Last Name:MARSHALL
Authorized Official - Suffix:
Authorized Official - Credentials:RMC
Authorized Official - Phone:773-435-9036
Mailing Address - Street 1:1455 N MILWAUKEE AVE FL 2
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60622-2015
Mailing Address - Country:US
Mailing Address - Phone:773-435-9036
Mailing Address - Fax:773-770-4626
Practice Address - Street 1:1455 N MILWAUKEE AVE FL 2
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60622-2015
Practice Address - Country:US
Practice Address - Phone:773-435-9036
Practice Address - Fax:773-770-4626
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:VIOS FERTILITY INSTITUTE CHICAGO, LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2018-01-22
Last Update Date:2023-05-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207VE0102XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyReproductive EndocrinologyGroup - Single Specialty