Organization Active NPI

Lifeforce Chiropractic, S.C.

  • Nutrition Chiropractor
  • Racine, WI
National Provider Identifier
1407044811
Registry record updated Jul 16, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nutrition ChiropractorTaxonomy code 111NN1001X
Legal business name
LIFEFORCE CHIROPRACTIC, S.C.
Practice address
3204 Washington Ave
Racine, WI 53405-3037
Phone
(262) 633-8160
Fax
(262) 633-3512
NPI assigned
Oct 10, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 16, 2025

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

Authorized official

Name
Dr. Irene Louise Parent, D.C.NPI 1619042983
Title
Doctor of Chiropractic
Phone
(262) 633-8160

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
Nutrition ChiropractorGroup: 193400000X SINGLE SPECIALTY GROUP 111NN1001X Primary

Addresses

Primary practice location

3204 Washington Ave
Racine, WI 53405-3037

Mailing address

1117 Arthur Ave
Racine, WI 53405-2902
Phone (262) 633-8160

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20120113000791 WI Part B Supplier - Clinic/Group Practice 7719154723 Receives reassigned benefits from 1 practitioner
Practice locations: Racine, WI

National Provider Directory

National Provider Directory

Locations

3204 Washington Ave
Racine, WI 53405
Phone (262) 633-8160

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": "1191974400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1752624000000",
    "number": "1407044811",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1117 ARTHUR AVE",
            "city": "RACINE",
            "state": "WI",
            "postal_code": "534052902",
            "telephone_number": "262-633-8160",
            "fax_number": "262-633-3512"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3204 WASHINGTON AVE",
            "city": "RACINE",
            "state": "WI",
            "postal_code": "534053037",
            "telephone_number": "262-633-8160",
            "fax_number": "262-633-3512"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIFEFORCE CHIROPRACTIC, S.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-10-10",
        "last_updated": "2025-07-16",
        "certification_date": "2025-07-09",
        "status": "A",
        "authorized_official_last_name": "PARENT",
        "authorized_official_first_name": "IRENE",
        "authorized_official_middle_name": "LOUISE",
        "authorized_official_title_or_position": "DOCTOR OF CHIROPRACTIC",
        "authorized_official_telephone_number": "262-633-8160",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111NN1001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor, Nutrition",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Racine, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 16, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.