Team Anti-Aging Center Inc

Primary specialty

Physical Therapy Clinic/CenterTaxonomy code 261QP2000X

License

038005767 Issued in IL

Legal business name

TEAM ANTI-AGING CENTER INC

Practice address

222 W Ontario St
Suite 503
Chicago, IL 60654-3652

Phone

(773) 735-5200

Fax

(773) 735-8656

NPI assigned

Mar 9, 2016

Organization subpart

No

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

Authorized official

Name

Dr. James Stoxen

Title

President

Phone

(773) 735-5200

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Team Doctors Doing business as

Tax ID family

Team Anti-Aging Center Inc2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Team Anti-Aging Center Inc

  • Chiropractor
  • Chicago, IL
  • NPI 1972951747
  NPD tax ID

Locations

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

{
    "created_epoch": "1457481600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1457481600000",
    "number": "1508227216",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "222 W ONTARIO ST",
            "address_2": "SUITE 503",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606543652",
            "telephone_number": "773-735-5200",
            "fax_number": "773-735-8656"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "222 W ONTARIO ST",
            "address_2": "SUITE 503",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606543652",
            "telephone_number": "773-735-5200",
            "fax_number": "773-735-8656"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TEAM ANTI-AGING CENTER INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-03-09",
        "last_updated": "2016-03-09",
        "status": "A",
        "authorized_official_last_name": "STOXEN",
        "authorized_official_first_name": "JAMES",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "773-735-5200",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": "IL",
            "license": "038005767",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ILLINOIS STATE LICENSE NUMBER",
            "identifier": "038005767",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Team Doctors",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Laura Teague
• Norris Wendell Teague, LSW
• Renie Arielle Teague, CRNA
• Taha Abdelmonem Anwar Teaima
• Ariel Teal
• Team Anti-Aging Center Inc
• Team Behavioral Health
• Team Dental Family Dentistry LLC
• Team Fraher Inc
• Team Med PC

• Physical Therapy Clinic/Center in Chicago, IL
• Providers in Chicago, IL by specialty
• Physical Therapy Clinic/Center in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 9, 2016; 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.