Provider Demographics
NPI:1083423875
Name:HEALTHVAX, LLC
Entity type:Organization
Organization Name:HEALTHVAX, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF OPERATING OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:CATHERINE
Authorized Official - Middle Name:RAE
Authorized Official - Last Name:KEATS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:502-322-7622
Mailing Address - Street 1:1744 OAK AVE
Mailing Address - Street 2:
Mailing Address - City:EVANSTON
Mailing Address - State:IL
Mailing Address - Zip Code:60201-2287
Mailing Address - Country:US
Mailing Address - Phone:502-322-7622
Mailing Address - Fax:
Practice Address - Street 1:6501 S CASS AVE
Practice Address - Street 2:
Practice Address - City:WESTMONT
Practice Address - State:IL
Practice Address - Zip Code:60559-3200
Practice Address - Country:US
Practice Address - Phone:630-960-2026
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-01-06
Last Update Date:2025-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251K00000XAgenciesPublic Health or Welfare