Srs Men's Vitality Hub
NPI 1194589432ActiveOrganization· Nurse Practitioner, Family· Tinley Park, IL
Nurse Practitioner, Family in Tinley Park, Illinois, registered in NPPES in February 2024. The authorized official on file is Shannon Rose Lewis, FNP, Provider, Owner.
Overview
| NPI | 1194589432 |
|---|---|
| Status | Active |
| Entity type | Organization |
| NPI issued | Feb 7, 2024 |
| Last updated in NPPES | Feb 7, 2024 |
| Certified by provider | Feb 7, 2024 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Nurse Practitioner, Family Primary | 363LF0000X | — | — |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Oct 9, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 4, 2026 | No match | — |
| New York OMIG · Nov 4, 2026 | No match | — |
| Ohio Medicaid · Nov 4, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 4, 2026 | No match | — |
| Washington HCA · Nov 4, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Not in the public enrollment file of Oct 1, 2026 |
|---|
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