Lifesource Health and Wellness Center LLC

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

038-006490 Issued in IL

Legal business name

LIFESOURCE HEALTH AND WELLNESS CENTER LLC

Practice address

1136 Bloomingdale Road
Glendale Heights, IL 60139

Phone

(630) 690-4488

Fax

(630) 690-4680

NPI assigned

Feb 11, 2010

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Luke P Sena, DCNPI 1003144841

Title

DC/Owner

Phone

(630) 690-4488

Specialties & licenses 1

Addresses

Other names 1

• LIFESOURCE HEALTH AND WELLNESS CENTER Former legal business name

Medicare fee-for-service enrollment

Enrolled in IL

Enrollment records 1

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Luke P Sena, DC

  • Chiropractor
  • Glendale Heights, IL
  • NPI 1003144841
  Medicare reassignment Authorized official
• Jay Dale Breitlow, D.C.

  • Chiropractor
  • Longmont, CO
  • NPI 1750619771
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1265846400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1678320000000",
    "number": "1023340346",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1136 BLOOMINGDALE ROAD",
            "city": "GLENDALE HEIGHTS",
            "state": "IL",
            "postal_code": "60139",
            "telephone_number": "630-690-4488",
            "fax_number": "630-690-4680"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1136 BLOOMINGDALE ROAD",
            "city": "GLENDALE HEIGHTS",
            "state": "IL",
            "postal_code": "60139",
            "telephone_number": "630-690-4488",
            "fax_number": "630-690-4680"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIFESOURCE HEALTH AND WELLNESS CENTER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-02-11",
        "last_updated": "2023-03-09",
        "certification_date": "2023-03-09",
        "status": "A",
        "authorized_official_last_name": "SENA",
        "authorized_official_first_name": "LUKE",
        "authorized_official_middle_name": "P",
        "authorized_official_title_or_position": "DC/OWNER",
        "authorized_official_telephone_number": "630-690-4488",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "IL",
            "license": "038-006490",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "LIFESOURCE HEALTH AND WELLNESS CENTER",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

• Krishna Pharmacy Inc.
• Halina Krok, PTA
• Katarzyna M Lazarczuk, PT
• Angela Lega, LCSW
• Alex Leiser
• Tara Marie Lindstrom, PSY.D
• Sherieka A Linzy
• Debra Locklear
• Dennis Long, DHSC, CCP
• Luis Granados DDS PC

• Chiropractor in Glendale Heights, IL
• Providers in Glendale Heights, IL by specialty
• Chiropractor in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 9, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.