LIVE IGNITE THRIVE LIMITED


Address: 6564 Marble Ln, Carpentersville, IL 60110-2494
Phone: 8474526533

LIVE IGNITE THRIVE LIMITED (NPI# 1184221004) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1184221004
Entity Type Organization
Organization Name LIVE IGNITE THRIVE LIMITED
Practice Address 6564 Marble Ln
Carpentersville
IL 60110-2494
Practice Telephone 8474526533
Mailing Telephone 8474526533
Enumeration Date 2020-10-04
Last Update Date 2020-10-04
Authorized Official Name ADAM WELDZIUS (MEDICAL DIRECTOR)
Authorized Official Telephone 8474526533
Is Organization Subpart N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 261QM1300X Clinic/Center
Specialization: Multi-Specialty
Ambulatory Health Care Facilities

Office Location

Street Address 6564 MARBLE LN
City CARPENTERSVILLE
State IL
Zip Code 60110-2494

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1275847311 Phillip Nelson Gonzalez Physical Therapist 62 S. Kennedy Dr., Carpentersville, IL 60110 2010-07-30
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Taxonomy Information

Taxonomy Code 261QM1300X
Grouping Ambulatory Health Care Facilities
Classification Clinic/Center
Specialization Multi-Specialty

Taxonomy Definition

Definition to come...

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Competitor

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City CARPENTERSVILLE
Zip Code 60110

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Dataset Information

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.

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