NPIMap

Organization Active NPI

Ageless Men's Health Holdings Inc

Doing business as Ageless Men's Health

  • Adult Medicine Physician
  • Chicago, IL
National Provider Identifier
1114448644
Registry record updated Oct 16, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Medicine PhysicianTaxonomy code 207QA0505X
Legal business name
AGELESS MEN'S HEALTH HOLDINGS INC
Doing business as
Ageless Men's Health
Practice address
1729 N Clybourn Ave
Chicago, IL 60614-6503
Phone
(312) 291-8335
Fax
(312) 291-8337
NPI assigned
Jul 6, 2017
Last updated
Oct 16, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 16, 2026

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

Authorized official

Name
Amanda Wilkinson
Title
Director of Business Operations
Phone
(602) 796-2559

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207QA0505X Primary

Addresses

Primary practice location

1729 N Clybourn Ave
Chicago, IL 60614-6503

Mailing address

10501 W Gowan Rd Ste 200
Las Vegas, NV 89129-6602
Phone (725) 204-6055

Other practice location 1

1535 Lake Cook Rd Ste 212
Northbrook, IL 60062-1451
Phone (312) 374-3947

Other practice location 2

1325 Wiley Rd Ste 164
Schaumburg, IL 60173-4355
Phone (630) 317-7690

Other names 1

  • Ageless Men's Health Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Ageless Men's Health18 organizations share this tax ID, including this one

Other organizations with this tax ID 17

Organizations that report the same tax identification number in the National Provider Directory.

View all 17

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1499299200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1792108800000",
    "number": "1114448644",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10501 W GOWAN RD STE 200",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891296602",
            "telephone_number": "725-204-6055",
            "fax_number": "725-204-6055"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1729 N CLYBOURN AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606146503",
            "telephone_number": "312-291-8335",
            "fax_number": "312-291-8337"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1535 Lake Cook Rd Ste 212",
            "address_purpose": "LOCATION",
            "city": "Northbrook",
            "state": "IL",
            "postal_code": "600621451",
            "country_code": "US",
            "telephone_number": "312-374-3947",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1325 Wiley Rd Ste 164",
            "address_purpose": "LOCATION",
            "city": "Schaumburg",
            "state": "IL",
            "postal_code": "601734355",
            "country_code": "US",
            "telephone_number": "630-317-7690",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "AGELESS MEN'S HEALTH HOLDINGS INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-07-06",
        "last_updated": "2026-10-16",
        "certification_date": "2026-10-16",
        "status": "A",
        "authorized_official_last_name": "WILKINSON",
        "authorized_official_first_name": "AMANDA",
        "authorized_official_title_or_position": "DIRECTOR OF BUSINESS OPERATIONS",
        "authorized_official_telephone_number": "602-796-2559"
    },
    "taxonomies": [
        {
            "code": "207QA0505X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine, Adult Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Ageless Men's Health",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Chicago, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 16, 2026; 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.