Provider Demographics
NPI:1861903213
Name:VOURVAHIS, VASILIKI
Entity type:Individual
Prefix:
First Name:VASILIKI
Middle Name:
Last Name:VOURVAHIS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8544 MASON AVE
Mailing Address - Street 2:
Mailing Address - City:MORTON GROVE
Mailing Address - State:IL
Mailing Address - Zip Code:60053-3312
Mailing Address - Country:US
Mailing Address - Phone:847-445-3821
Mailing Address - Fax:
Practice Address - Street 1:164 S PROSPECT AVE
Practice Address - Street 2:
Practice Address - City:PARK RIDGE
Practice Address - State:IL
Practice Address - Zip Code:60068-4035
Practice Address - Country:US
Practice Address - Phone:847-318-8122
Practice Address - Fax:847-318-8122
Is Sole Proprietor?:No
Enumeration Date:2017-10-12
Last Update Date:2017-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator