NPIMap

Organization Active NPI

Life Health and Wellness, PLLC

  • Primary Care Clinic/Center
  • Flossmoor, IL
National Provider Identifier
1750964714
Registry record updated Dec 29, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Clinic/CenterTaxonomy code 261QP2300X
Legal business name
LIFE HEALTH AND WELLNESS, PLLC
Practice address
1835 Dixie Hwy Ste 104
Flossmoor, IL 60422-1974
Phone
(312) 285-2100
Fax
(312) 285-2854
NPI assigned
Apr 28, 2021
Last updated
Dec 29, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 29, 2023

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

Authorized official

Name
Dr. Vonnise Renee' Hussey, DNP, APN, FNP-BCNPI 1902379621
Title
Owner/Doctorate FNP
Phone
(312) 285-2100

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 207Q00000X
Primary Care Clinic/Center 261QP2300X Primary

Addresses

Primary practice location

1835 Dixie Hwy Ste 104
Flossmoor, IL 60422-1974

Mailing address

1835 Dixie Hwy Ste 104
Flossmoor, IL 60422-1974
Phone (312) 285-2100

Other names 1

  • LIFE HEALTH AND WELLNESS Former legal business name

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
14D2256372Life Health and Wellness, PLLC1835 Dixie Hwy - Ste 104, Flossmoor, IL 60422Certificate of waiverMar 22, 2028

National Provider Directory

National Provider Directory

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/24946/brand/1/csg/1/fhir/r4

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1619568000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1703808000000",
    "number": "1750964714",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1835 DIXIE HWY STE 104",
            "city": "FLOSSMOOR",
            "state": "IL",
            "postal_code": "604221974",
            "telephone_number": "312-285-2100",
            "fax_number": "312-285-2854"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1835 DIXIE HWY STE 104",
            "city": "FLOSSMOOR",
            "state": "IL",
            "postal_code": "604221974",
            "telephone_number": "312-285-2100",
            "fax_number": "312-285-2854"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIFE HEALTH AND WELLNESS, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-04-28",
        "last_updated": "2023-12-29",
        "certification_date": "2023-12-29",
        "status": "A",
        "authorized_official_last_name": "HUSSEY",
        "authorized_official_first_name": "VONNISE",
        "authorized_official_middle_name": "RENEE'",
        "authorized_official_title_or_position": "OWNER/DOCTORATE FNP",
        "authorized_official_telephone_number": "312-285-2100",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DNP, APN, FNP-BC"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "LIFE HEALTH AND WELLNESS",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

Other providers in Flossmoor, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 29, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.