Life Enhancement Services of Il, LLC

Primary specialty

Community/Behavioral Health AgencyTaxonomy code 251S00000X

Legal business name

LIFE ENHANCEMENT SERVICES OF IL, LLC

Practice address

500 N Michigan Ave
Ste 600
Chicago, IL 60611-3777

Phone

(704) 342-9595

NPI assigned

Jun 19, 2014

Organization subpart

No

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

Authorized official

Name

Mr. Herbert Gray

Title

Ceo/Owner

Phone

(704) 342-9595

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1403136000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1403136000000",
    "number": "1700290533",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9700 RESEARCH DR",
            "address_2": "SUITE 111",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282628552"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 N MICHIGAN AVE",
            "address_2": "STE 600",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606113777",
            "telephone_number": "704-342-9595"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIFE ENHANCEMENT SERVICES OF IL, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-06-19",
        "last_updated": "2014-06-19",
        "status": "A",
        "authorized_official_last_name": "GRAY",
        "authorized_official_first_name": "HERBERT",
        "authorized_official_title_or_position": "CEO/OWNER",
        "authorized_official_telephone_number": "704-342-9595",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Life Enhancement Health Care Institute
• Life Forward Therapy
• Life Fulfillment Consultants, LLC
• Life Gate Pharmacy LLC
• Life in Color Counseling LLC
• Life Made Krystal Clear LLC

• Community/Behavioral Health Agency in Chicago, IL
• Providers in Chicago, IL by specialty
• Community/Behavioral Health Agency in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 19, 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.