Organization Active NPI

Lifeline Chiropractic

  • Chiropractor
  • Olympia Fields, IL
National Provider Identifier
1174534580
Registry record updated Aug 13, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
038-008544 Issued in IL
Legal business name
LIFELINE CHIROPRACTIC
Practice address
3486 W. Vollmer
Olympia Fields, IL 60461
Phone
(708) 481-5444
Fax
(708) 585-6226
NPI assigned
Aug 10, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 13, 2008

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

Authorized official

Name
Mark Lagerkvist, D.C.NPI 1578574604
Title
President
Phone
(708) 481-5444

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 1

Specialty (taxonomy)CodeLicenseStatePrimary
ChiropractorGroup: 193200000X MULTI-SPECIALTY GROUP 111N00000X 038-008544 IL Primary

Addresses

Primary practice location

3486 W. Vollmer
Olympia Fields, IL 60461

Mailing address

3486 W. Vollmer
Olympia Fields, IL 60461
Phone (708) 481-5444

National Provider Directory

National Provider Directory

Locations

3486 Vollmer Rd
Olympia Flds, IL 60461
Phone (708) 316-9130

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": "1155168000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1218585600000",
    "number": "1174534580",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3486 W. VOLLMER",
            "city": "OLYMPIA FIELDS",
            "state": "IL",
            "postal_code": "60461",
            "telephone_number": "708-481-5444",
            "fax_number": "708-585-6226"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3486 W. VOLLMER",
            "city": "OLYMPIA FIELDS",
            "state": "IL",
            "postal_code": "60461",
            "telephone_number": "708-481-5444",
            "fax_number": "708-585-6226"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIFELINE CHIROPRACTIC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-10",
        "last_updated": "2008-08-13",
        "status": "A",
        "authorized_official_last_name": "LAGERKVIST",
        "authorized_official_first_name": "MARK",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "708-481-5444",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Chiropractor",
            "state": "IL",
            "license": "038-008544",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Olympia Fields, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 13, 2008; 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.