NPIMap

Organization Active NPI

Lifecore SC

  • Psychiatry Physician
  • Lemont, IL
National Provider Identifier
1356395396
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
Legal business name
LIFECORE SC
Practice address
106 Stephen St
LL4
Lemont, IL 60439-3674
Phone
(630) 243-0145
Fax
(630) 257-0854
NPI assigned
May 22, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Authorized official

Name
Cheryl Beadle
Title
President
Phone
(630) 243-0145

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2084P0800X IL Primary

Addresses

Primary practice location

106 Stephen St
LL4
Lemont, IL 60439-3674

Mailing address

14234 S Bell Rd
#137
Homer Glen, IL 60491-8122
Phone (630) 243-0145

National Provider Directory

National Provider Directory

Locations

1940 Nerge Rd
Elk Grove Vlg, IL 60007
Phone (847) 301-0550

106 Stephen St
Ste LL4
Lemont, IL 60439
Phone (630) 243-0145

130 Quail Ridge Dr
Westmont, IL 60559
Phone (630) 734-8470

Practitioners & affiliated clinicians

Practitioners 11

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": "1148256000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658361600000",
    "number": "1356395396",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14234 S BELL RD",
            "address_2": "#137",
            "city": "HOMER GLEN",
            "state": "IL",
            "postal_code": "604918122",
            "telephone_number": "630-243-0145",
            "fax_number": "630-257-0854"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "106 STEPHEN ST",
            "address_2": "LL4",
            "city": "LEMONT",
            "state": "IL",
            "postal_code": "604393674",
            "telephone_number": "630-243-0145",
            "fax_number": "630-257-0854"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIFECORE SC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-22",
        "last_updated": "2022-07-21",
        "status": "A",
        "authorized_official_last_name": "BEADLE",
        "authorized_official_first_name": "CHERYL",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "630-243-0145"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lemont, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; 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.