Basic Information
Provider Information
NPI: 1821741737
EntityType: 2
ReplacementNPI:  
OrganizationName: VITUITY - ILLINOIS INFECTIOUS DISEASE SPECIALISTS, P.C.
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Mailing Information
Address1: 2100 POWELL ST STE 400
Address2:  
City: EMERYVILLE
State: CA
PostalCode: 946081872
CountryCode: US
TelephoneNumber: 5103502600
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Practice Location
Address1: 200 HEALTH CARE DR
Address2:  
City: GREENVILLE
State: IL
PostalCode: 622461154
CountryCode: US
TelephoneNumber: 6186641230
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Other Information
ProviderEnumerationDate: 01/31/2022
LastUpdateDate: 01/31/2022
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AuthorizedOfficialLastName: BIRDSALL
AuthorizedOfficialFirstName: DAVID
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AuthorizedOfficialTitleorPosition: ADMINISTRATIVE VP OF OPERATIONS
AuthorizedOfficialTelephone: 5108517552
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IsOrganizationSubpart: N
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AuthorizedOfficialCredential: M.D
NPICertificationDate: 01/31/2022

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207RI0200X  Y193200000X MULTI-SPECIALTY GROUPAllopathic & Osteopathic PhysiciansInternal MedicineInfectious Disease

No ID Information.


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