Lifelong Access

Primary specialty

Developmental - Behavioral Pediatrics PhysicianTaxonomy code 2080P0006X

Legal business name

LIFELONG ACCESS

Practice address

1302 Franklin Ave Ste L500
Normal, IL 61761-3551

Phone

(309) 452-0069

NPI assigned

Jan 3, 2023

Organization subpart

No

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

Authorized official

Name

Patrick Dyce Bailey

Title

Program Supports Specialist

Phone

(309) 451-8888

Specialties & licenses 1

Addresses

Other names 1

• Marcfirst Former legal business name

Tax ID family

Lifelong Access3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

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

• Lifelong Access

  • Behavior Analyst
  • Normal, IL
  • NPI 1831730092
  NPD tax ID
• Lifelong Access

  dba Marc

  • Speech-Language Pathologist
  • Normal, IL
  • NPI 1891701389
  NPD tax ID

Locations

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

{
    "created_epoch": "1672704000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1724716800000",
    "number": "1124731484",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2000 JACOBSSEN DR",
            "city": "NORMAL",
            "state": "IL",
            "postal_code": "617616277",
            "telephone_number": "309-451-8888",
            "fax_number": "309-451-8989"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1302 FRANKLIN AVE STE L500",
            "city": "NORMAL",
            "state": "IL",
            "postal_code": "617613551",
            "telephone_number": "309-452-0069"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIFELONG ACCESS",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-01-03",
        "last_updated": "2024-08-27",
        "certification_date": "2024-08-27",
        "status": "A",
        "authorized_official_last_name": "BAILEY",
        "authorized_official_first_name": "PATRICK",
        "authorized_official_middle_name": "DYCE",
        "authorized_official_title_or_position": "PROGRAM SUPPORTS SPECIALIST",
        "authorized_official_telephone_number": "309-451-8888"
    },
    "taxonomies": [
        {
            "code": "2080P0006X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Pediatrics, Developmental - Behavioral Pediatrics",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Marcfirst",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

• Andrew James Lerrick, M.D.
• Alan Levy, CNIM
• Julie Lewis, M.D.
• Lawrence K.C. Li, M.D.
• Taylor Liccar, DC
• Lifelong Access
• Lifelong Access (Marc)
• Allyson Kay Lindgren, APRN
• Keith E Liptock
• Christie M Little, RN, BSN

• Developmental - Behavioral Pediatrics Physician in Normal, IL
• Providers in Normal, IL by specialty
• Developmental - Behavioral Pediatrics Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 27, 2024; 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.