Organization Active NPI

Life Forward Therapy

  • Clinic/Center
  • Chicago, IL
National Provider Identifier
1407650328
Registry record updated Oct 8, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinic/CenterTaxonomy code 261Q00000X
Legal business name
LIFE FORWARD THERAPY
Practice address
3502 N Wilton Ave # 1
Chicago, IL 60657-1742
Phone
(847) 420-3256
NPI assigned
Apr 1, 2025
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 8, 2025

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

Authorized official

Name
Caroline BurkeNPI 1457734287
Title
Owner
Phone
(847) 420-3256

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
Clinic/Center 261Q00000X Primary

Addresses

Primary practice location

3502 N Wilton Ave # 1
Chicago, IL 60657-1742

Mailing address

1728 N Wood St Apt 1F
Chicago, IL 60622-1359
Phone (847) 420-3256

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.

NPI Registry JSON

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

{
    "created_epoch": "1743465600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1759881600000",
    "number": "1407650328",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1728 N WOOD ST APT 1F",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606221359",
            "telephone_number": "847-420-3256"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3502 N WILTON AVE # 1",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606571742",
            "telephone_number": "847-420-3256"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIFE FORWARD THERAPY",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-04-01",
        "last_updated": "2025-10-08",
        "certification_date": "2025-10-08",
        "status": "A",
        "authorized_official_last_name": "BURKE",
        "authorized_official_first_name": "CAROLINE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "847-420-3256"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": null,
            "license": null,
            "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 Oct 8, 2025; 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.