Lifestyle Rejuvenation Medical Group Pllc
LBN: Lifestyle Rejuvenation Medical Group Pllc
Lifestyle Rejuvenation Medical Group Pllc is an health care organization with primary practice located at 1740 E 55Th Street , Chicago IL 60615. The organization recently has 15 registered licenses in different health care specialties including Chiropractic Providers / Chiropractor, Chiropractic Providers / Rehabilitation, Ambulatory Health Care Facilities / Health Service, Ambulatory Health Care Facilities / Multi-Specialty, Ambulatory Health Care Facilities / Medical Specialty, Ambulatory Health Care Facilities / Physical Therapy, Ambulatory Health Care Facilities / Primary Care, Ambulatory Health Care Facilities / Pain, Ambulatory Health Care Facilities / Radiology, Ambulatory Health Care Facilities / Rehabilitation, Ambulatory Health Care Facilities / Recovery Care, Managed Care Organizations / Health Maintenance Organization, Managed Care Organizations / Preferred Provider Organization, Managed Care Organizations / Point of Service, Suppliers / Durable Medical Equipment & Medical Supplies. Ambulatory Health Care Facilities / Multi-Specialty is the primary health care specialty.
Lifestyle Rejuvenation Medical Group Pllc can be contacted via phone (773) 667-9053, or through Higginbottom, Robert Van via phone (773) 667-9053.
Contact Information
Primary practice address
1740 E 55Th Street
Chicago IL 60615
Phone: (773) 667-9053
Fax:
Website:
Authorized official contact:
Name: Higginbottom, Robert Van Doctor of Chiropractic (DC)
Phone: (773) 667-9053
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Chiropractic Providers / Chiropractor | 111N00000X | ||
| Chiropractic Providers / Rehabilitation | 111NR0400X | ||
| Ambulatory Health Care Facilities / Health Service | 261QH0100X | ||
| Ambulatory Health Care Facilities / Multi-Specialty | 261QM1300X | ||
| Ambulatory Health Care Facilities / Medical Specialty | 261QM2500X | ||
| Ambulatory Health Care Facilities / Physical Therapy | 261QP2000X | ||
| Ambulatory Health Care Facilities / Primary Care | 261QP2300X | ||
| Ambulatory Health Care Facilities / Pain | 261QP3300X | ||
| Ambulatory Health Care Facilities / Radiology | 261QR0200X | ||
| Ambulatory Health Care Facilities / Rehabilitation | 261QR0400X | ||
| Ambulatory Health Care Facilities / Recovery Care | 261QR0800X | ||
| Managed Care Organizations / Health Maintenance Organization | 302R00000X | ||
| Managed Care Organizations / Preferred Provider Organization | 305R00000X | ||
| Managed Care Organizations / Point of Service | 305S00000X | ||
| Suppliers / Durable Medical Equipment & Medical Supplies | 332B00000X |
Profile Details
| NPI number | 1134781974 |
|---|---|
| LBN Legal business name | Lifestyle Rejuvenation Medical Group Pllc |
| DBA Doing business as | |
| Authorized official | Higginbottom, Robert Van Doctor of Chiropractic (DC) |
| Entity | Organization |
| Organization subpart 1 | No |
| Enumeration date | Jul 2nd, 2019 |
| Last updated | May 29th, 2020 - about 6 years ago |
1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.
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