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VITAL FAMILY HEALTHCARE LLC.
NPI 1417647066
Clinic/Center in Belvidere, IL

Active since May 08, 2023CLIA 14D2283030 · Waiver
1004 LOGAN AVE, BELVIDERE, IL 61008(815) 482-6365 Get Directions Write a Review

NPPES record last updated: April 12, 2026. Verified against the NPPES registry weekly; last sync: November 08, 2026.

Record update history: Apr 12, 2026, Apr 4, 2026, Aug 29, 2023 and 1 more (4 updates tracked since 2023).

About Vital Family Healthcare Llc. NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

VITAL FAMILY HEALTHCARE LLC. (NPI 1417647066), doing business as Clinic Of Belvidere, is a healthcare organization registered as a clinic/center in Belvidere, Illinois and active in the NPI registry since May 2023. The organization holds a CLIA Waiver certificate valid through May 30, 2027, maintains a secondary practice location in South Elgin, and lists Jaclyn Newhart, Manager, as its authorized official.

NPPES Registry Identity

NPI1417647066
Entity TypeOrganization
Primary Taxonomy261Q00000X
Legal Business NameVITAL FAMILY HEALTHCARE LLC.
Location Address1004 LOGAN AVEBelvidere, IL 61008
Mailing Address1004 Logan AveBelvidere, IL 61008-3955 · (815) 482-6365
Phone(815) 482-6365
Organization SubpartNo
Authorized OfficialJaclyn NewhartManager · (815) 482-6365
Enumeration DateMay 8, 2023
Last NPPES UpdateApril 12, 20264 updates tracked since enumeration
NPPES CertifiedApril 12, 2026
✔ NPI 1417647066 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyClinic/CenterAmbulatory Health Care Facilities
Taxonomy Code261Q00000X
Definition
A facility or distinct part of one used for the diagnosis and treatment of outpatients. Clinic/Center is irregularly defined, sometimes being limited to organizations serving specialized treatment requirements or distinct patient/client groups (e.g., radiology, poor, and public health).
Also ListedNurse PractitionerTaxonomy 363L00000X
1004 LOGAN AVE, Belvidere, IL 61008
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Other Names 2

Doing Business AsClinic Of Belvidere
Doing Business AsClinic Of South Elgin

Secondary Practice Location 1

Location 185 Woodbury StSouth Elgin, IL 60177-1327 · Phone (224) 238-8252 · Fax (815) 604-8076

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter Health.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Vital Family Healthcare Llc. is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

3

Medicare enrollment records show 3 clinicians reassign Medicare billing to Vital Family Healthcare LLC., which bills Medicare for the services they deliver. Of these, 1 practice at this address. They are listed nearest first.

Clinicians, nearest first (3)

Eileen Solis, FNP-BC
Nurse Practitioner
NPI 1699277038
1004 LOGAN AVE
Belvidere, IL 61008
(847) 482-6365
✔ PECOS✔ Accepts MedicareSame address
Ferdinand Catotal, FNP
Nurse Practitioner
NPI 1538681572
1554 TODD FARM DR
Elgin, IL 60123
(847) 888-7423
✔ PECOS✔ Accepts Medicare29 mi
Kyla Massimb, FNP-BC
Nurse Practitioner
NPI 1548013360
85 WOODBURY ST
South Elgin, IL 60177
(224) 238-8252
✔ PECOS✔ Accepts Medicare33 mi

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 14D2283030

Vital Family Healthcare · Belvidere, IL
Active · expires May 30, 2027
CLIA Number14D2283030
Laboratory TypeCommunity Clinic
Certificate Effective DateMay 31, 2025
Certificate Expiration DateMay 30, 2027
Laboratory DirectorJaclyn Newhart
Laboratory Phone(708) 653-2396
Laboratory LocationVital Family Healthcare1004 Logan Ave, Belvidere, IL 61008
CLIA data matches this NPI record on: Address Name
This certificate is issued to a laboratory to perform only waived tests.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Vital Family Healthcare LLC.'s NPI number?

The NPI number for Vital Family Healthcare LLC. is 1417647066. It was assigned to this organization in the NPPES registry on May 8, 2023. The provider is doing business as Clinic of Belvidere and Clinic of South Elgin.

Where is Vital Family Healthcare LLC. located?

Vital Family Healthcare LLC. is located at 1004 Logan Ave, Belvidere, IL 61008. The listed phone number is (815) 482-6365.

What is Vital Family Healthcare LLC.'s specialty?

The primary specialty registered for this NPI is Clinic/Center with taxonomy code 261Q00000X.

Is Vital Family Healthcare LLC. enrolled in Medicare?

Yes. Vital Family Healthcare LLC. is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Vital Family Healthcare LLC.?

According to the CMS Revalidation Reassignment List (October 2026 release), 3 clinicians, all in Nurse Practitioner, reassign their Medicare billing to Vital Family Healthcare LLC.. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. Of these, 1 practice at this address. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Does Vital Family Healthcare LLC. hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 14D2283030) is associated with this NPI, valid through May 30, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

What insurance does Vital Family Healthcare LLC. accept?

Health plans from Ambetter Health list Vital Family Healthcare LLC. as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Vital Family Healthcare LLC. was last updated on April 12, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 7 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.