Organization · Type 2 NPI
Si Vitality Specialty Clinic LLC
Family Nurse Practitioner · Carterville, IL
NPI number
1760286413
Active
Practice location
209 W Commercial Dr Ste E
Carterville, IL 62918-2057
Fax (618) 822-4045
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Multi-Specialty Clinic/Center | 261QM1300X | None listed |
| Family Nurse Practitioner Primary | 363LF0000X | None listed |
Family Nurse Practitioner: Definition to come...
Another provider at this address
About NPI 1760286413
Si Vitality Specialty Clinic LLC's National Provider Identifier is 1760286413, issued on Apr 2, 2025. The primary taxonomy on file is Family Nurse Practitioner (363LF0000X), and the practice location is in Carterville, IL. The record was last updated on Oct 26, 2026.