NPIMap

Organization Active NPI

Full Life Centers, LLC

  • Counselor
  • Chicago, IL
National Provider Identifier
1619077385
Registry record updated Apr 30, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
CounselorTaxonomy code 101Y00000X
License
336046711 Issued in IL
Legal business name
FULL LIFE CENTERS, LLC
Practice address
2750 N Racine Ave
Suite #1
Chicago, IL 60614-1206
Phone
(773) 529-1200
Fax
(773) 296-6131
NPI assigned
Sep 23, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 30, 2014

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

Authorized official

Name
Dr. Joseph E Siegler, M.D.
Title
Owner
Phone
(773) 529-1200

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
CounselorGroup: 193400000X SINGLE SPECIALTY GROUP 101Y00000X 336046711 IL Primary

Addresses

Primary practice location

2750 N Racine Ave
Suite #1
Chicago, IL 60614-1206

Mailing address

2750 N Racine Ave
Suite #1
Chicago, IL 60614-1206
Phone (773) 529-1200

National Provider Directory

National Provider Directory

Locations

2750 N Racine Ave
Ste 1
Chicago, IL 60614
Phone (773) 529-1200

Practitioners & affiliated clinicians

Practitioners 3

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": "1158969600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1398816000000",
    "number": "1619077385",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2750 N RACINE AVE",
            "address_2": "SUITE #1",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606141206",
            "telephone_number": "773-529-1200",
            "fax_number": "773-296-6131"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2750 N RACINE AVE",
            "address_2": "SUITE #1",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606141206",
            "telephone_number": "773-529-1200",
            "fax_number": "773-296-6131"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FULL LIFE CENTERS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-23",
        "last_updated": "2014-04-30",
        "status": "A",
        "authorized_official_last_name": "SIEGLER",
        "authorized_official_first_name": "JOSEPH",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "773-529-1200",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Counselor",
            "state": "IL",
            "license": "336046711",
            "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 Apr 30, 2014; 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.