AGELESS MEN'S HEALTH HOLDINGS INC (NPI# 1114448644) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1114448644 |
| Entity Type | Organization |
| Organization Name | AGELESS MEN'S HEALTH HOLDINGS INC |
| Other Organization Name | AGELESS MEN'S HEALTH |
| Practice Address |
1729 N Clybourn Ave Chicago IL 60614-6503 |
| Practice Telephone | (312) 291-8335 |
| Practice Fax Number | 3122918337 |
| Mailing Telephone | 3122918335 |
| Mailing Fax Number | 3122918337 |
| Enumeration Date | 2017-07-06 |
| Last Update Date | 2017-07-06 |
| Authorized Official Name | MELISSA C MCCLELLAN (VP OF BUSINESS OPERATIONS) |
| Authorized Official Telephone | 9017573643 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 174400000X | Specialist | Other Service Providers |
| Other Name | Type Code |
|---|---|
| Ageless Men's Health | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1508207119 | Ageless Men's Health Holdings Inc | Specialist | 1132 E Draper Pkwy, Draper, UT 84020-9095 | 2013-07-11 |
| 1295252260 | Ageless Men's Health Holdings Inc | Family Medicine | 10601 San Jose Blvd Ste 208, Jacksonville, FL 32257-8203 | 2017-08-29 |
| Street Address |
1729 N CLYBOURN AVE |
| City | CHICAGO |
| State | IL |
| Zip Code | 60614-6503 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1518420462 | Patricia A Cedano | Nurse Practitioner | 1729 N Clybourn Ave, Chicago, IL 60614-6503 | 2019-04-08 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1487266516 | Taylor Connington | Pharmacist | 843 W Armitage Ave, Chicago, IL 60614 | 2020-08-19 |
| 1356975692 | Amarilis Diaz | Social Worker | Terry Hefter Associates, LLC, 1731 N. Marcey Suite 535, Chicago, IL 60614 | 2020-02-25 |
| 1457902975 | Michele Waggoner | Physical Therapist | 2515 N. Clark St, Chicago, IL 60614 | 2019-09-25 |
| 1669031936 | Justin Pomeroy | Acupuncturist | 1350 W. Schubert Ave., Chicago, IL 60614 | 2019-06-11 |
| 1801451547 | Amanda Harris | Counselor | 2451 N Lincoln Ave # 206, Chicago, IL 60614 | 2019-05-08 |
| 1780164574 | Danielle Trokey | Psychiatry & Neurology | 2515 N Clark St Ste 801, Chicago, IL 60614 | 2018-08-21 |
| 1841707353 | Madison Counseling Solutions LLC | Social Worker | 2502 N. Clark St., Chicago, IL 60614 | 2018-01-05 |
| 1386154011 | Allison Cooper Boyan | Occupational Therapist | 1640 N. Wells St., Unit 103, Chicago, IL 60614 | 2017-10-09 |
| 1245759653 | Eileen Davidson Siegel | Physician Assistant | 2073 N. Clybourn Ave., Chicago, IL 60614 | 2017-09-18 |
| 1447779814 | Elizabeth Hobart | Psychologist | 1800 W. Diversey Pkwy, Unit H, Chicago, IL 60614 | 2017-09-16 |
| Find all providers in zip 60614 | ||||
| Taxonomy Code | 174400000X |
| Grouping | Other Service Providers |
| Classification | Specialist |
| An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. |
| Notes: Source: Expanded from Webster’s II New Riverside University Dictionary, Boston: Riverside Publishing Company, 1974. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1346899630 | Jeremy Gantz Morse | Specialist | 815 W Buena Ave, Chicago, IL 60613-1694 | 2019-09-09 |
| 1619539632 | Benjamin Mendoza | Specialist | 6303 W 63rd St Unit 3c, Chicago, IL 60638-7015 | 2019-06-29 |
| 1811471808 | Judith M Penn | Specialist | 8312 S Kedzie Ave, Chicago, IL 60652-3309 | 2018-09-17 |
| 1841774825 | Matthew E Huggins | Specialist | 4553 W 56th St Apt 204c, Chicago, IL 60629-5389 | 2018-09-17 |
| 1750860177 | Muhammad Asim Khan | Specialist | 60 E Delaware Pl, Chicago, Il 60611, 14th Floor Urology- Andrology Clinic, Chicago, IL 60611 | 2018-08-07 |
| 1922502657 | Shauntay Robertson | Specialist | 7342 S Richmond St, Chicago, IL 60629-3015 | 2018-03-19 |
| 1447798871 | Andria Miller | Specialist | 840 N Western Ave, Chicago, IL 60622-4638 | 2017-02-06 |
| 1710425129 | Rtb Sc | Specialist | 5015 N. Paulina #225, Chicago, IL 60640 | 2017-02-06 |
| 1881137354 | Joy Deliverance Williamson | Specialist | 3863 W Flournoy St, Apt. 1w, Chicago, IL 60624-3617 | 2016-11-30 |
| 1174079883 | Cardinal Technical Sc | Specialist | 208 Lasalle Street, Suite 214, Chicago, IL 60604 | 2016-09-01 |
| Find all providers in CHICAGO | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.