NPIMap

Organization Active NPI

Living Well Health Management Inc

  • Exclusive Provider Organization
  • Chicago, IL
National Provider Identifier
1336408517
Registry record updated May 9, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Exclusive Provider OrganizationTaxonomy code 302F00000X
License
209009287 Issued in IL
Legal business name
LIVING WELL HEALTH MANAGEMENT INC
Practice address
4150 S Berkeley Ave
Chicago, IL 60653-3010
Phone
(773) 285-9100
Fax
(773) 451-2770
NPI assigned
May 9, 2012
Last updated
May 9, 2012By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 9, 2012

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

Authorized official

Name
Ida M DixonNPI 1871861260
Title
President
Phone
(773) 285-9100

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Exclusive Provider Organization 302F00000X 209009287 IL Primary

Addresses

Primary practice location

4150 S Berkeley Ave
Chicago, IL 60653-3010

Mailing address

4150 S Berkeley Ave
Chicago, IL 60653-3010
Phone (773) 285-9100

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, 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": "1336521600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1336521600000",
    "number": "1336408517",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4150 S BERKELEY AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606533010",
            "telephone_number": "773-285-9100",
            "fax_number": "773-451-2770"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4150 S BERKELEY AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606533010",
            "telephone_number": "773-285-9100",
            "fax_number": "773-451-2770"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIVING WELL HEALTH MANAGEMENT INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-05-09",
        "last_updated": "2012-05-09",
        "status": "A",
        "authorized_official_last_name": "DIXON",
        "authorized_official_first_name": "IDA",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "773-285-9100"
    },
    "taxonomies": [
        {
            "code": "302F00000X",
            "taxonomy_group": "",
            "desc": "Exclusive Provider Organization",
            "state": "IL",
            "license": "209009287",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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 May 9, 2012; 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.