| Doctor Name: | MR. JOSEPH ANDREW VITAGLIANO |
| NPI Number: | 1003242447 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | PA-C |
| License Number: | 5483 |
| Business Practice Address: | 5555 W Thunderbird Rd Glendale, AZ - 853064622 |
| Business Phone Number: | 6025885555 |
| Business Fax Number: | |
| Mailing Address: | 2000 Spring Rd, OAK BROOK |
| State: | IL |
| Postal Code: | 605231804 |
| Phone Number: | 6304728800 |
| Fax Number: | |
| NPI Enumeration Date: | 09/17/2013 |
| NPI Last Update Date: | 09/17/2013 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363AM0700X |
| License Number: | 5483 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | AZ |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Physician Assistant |
| Taxonomy Specialization: | Medical |
| Taxonomy Definition: | |