Active Healthcare, LTD

Primary specialty

Multi-Specialty Clinic/CenterTaxonomy code 261QM1300X

Legal business name

ACTIVE HEALTHCARE, LTD

Practice address

5315 N Sheridan Rd
Chicago, IL 60640-2531

Phone

(773) 275-3200

Fax

(773) 275-2877

NPI assigned

Apr 9, 2007

Organization subpart

No

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

Authorized official

Name

Dr. Leslie John Bulyaki, D.C.

Title

President

Phone

(773) 275-3200

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1176076800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1295858629",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5315 N SHERIDAN RD",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606402531",
            "telephone_number": "773-275-3200",
            "fax_number": "773-275-2877"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5315 N SHERIDAN RD",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606402531",
            "telephone_number": "773-275-3200",
            "fax_number": "773-275-2877"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ACTIVE HEALTHCARE, LTD",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-09",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "BULYAKI",
        "authorized_official_first_name": "LESLIE",
        "authorized_official_middle_name": "JOHN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "773-275-3200",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "261QM1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Multi-Specialty",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Multi-Specialty Clinic/Center in Chicago, IL
• Providers in Chicago, IL by specialty
• Multi-Specialty Clinic/Center in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.