NPIMap

Organization Active NPI

Life Synergy, LLC

  • Professional Counselor
  • Homer Glen, IL
National Provider Identifier
1114332004
Registry record updated Jun 30, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
180008797 Issued in IL
Legal business name
LIFE SYNERGY, LLC
Practice address
13235 W Hiawatha Dr
Homer Glen, IL 60491-8637
Phone
(708) 927-2449
NPI assigned
Jun 30, 2014
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 30, 2014

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

Authorized official

Name
Karen L Vachulcik, LCPCNPI 1265869986
Title
Licensed Clinical Prof Counselor
Phone
(708) 927-2449

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) CounselorGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 101YA0400X 30730 IL
Professional CounselorGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 101YP2500X 180008797 IL Primary

Addresses

Primary practice location

13235 W Hiawatha Dr
Homer Glen, IL 60491-8637

Mailing address

13235 W Hiawatha Dr
Homer Glen, IL 60491-8637

Other identifiers 2

IdentifierTypeStateIssuer
1265869986OtherILBCBS
1265869986OtherILAETNA

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

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

NPI Registry JSON

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

{
    "created_epoch": "1404086400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1404086400000",
    "number": "1114332004",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13235 W HIAWATHA DR",
            "city": "HOMER GLEN",
            "state": "IL",
            "postal_code": "604918637"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13235 W HIAWATHA DR",
            "city": "HOMER GLEN",
            "state": "IL",
            "postal_code": "604918637",
            "telephone_number": "708-927-2449"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIFE SYNERGY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-06-30",
        "last_updated": "2014-06-30",
        "status": "A",
        "authorized_official_last_name": "VACHULCIK",
        "authorized_official_first_name": "KAREN",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "LICENSED CLINICAL PROF COUNSELOR",
        "authorized_official_telephone_number": "708-927-2449",
        "authorized_official_credential": "LCPC"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "IL",
            "license": "30730",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Counselor, Professional",
            "state": "IL",
            "license": "180008797",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "1265869986",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "1265869986",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Homer Glen, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 30, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.