Lifewave Institute, LLC

Primary specialty

Rehabilitation ChiropractorTaxonomy code 111NR0400X

License

038010489 Issued in IL

Legal business name

LIFEWAVE INSTITUTE, LLC

Practice address

3113 Dundee Rd
Northbrook, IL 60062-2402

Phone

(224) 723-5693

Fax

(224) 723-5073

NPI assigned

Feb 15, 2012

Organization subpart

No

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

Authorized official

Name

Dr. Andrew B. Serlin, D.C.

Title

President, Lifewave Institute, LLC

Phone

(847) 530-8568

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1329264000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1329264000000",
    "number": "1780957274",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1445 GORDON TER",
            "city": "DEERFIELD",
            "state": "IL",
            "postal_code": "600154738",
            "telephone_number": "847-530-8568",
            "fax_number": "847-677-9927"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3113 DUNDEE RD",
            "city": "NORTHBROOK",
            "state": "IL",
            "postal_code": "600622402",
            "telephone_number": "224-723-5693",
            "fax_number": "224-723-5073"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIFEWAVE INSTITUTE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-02-15",
        "last_updated": "2012-02-15",
        "status": "A",
        "authorized_official_last_name": "SERLIN",
        "authorized_official_first_name": "ANDREW",
        "authorized_official_middle_name": "B.",
        "authorized_official_title_or_position": "PRESIDENT, LIFEWAVE INSTITUTE, LLC",
        "authorized_official_telephone_number": "847-530-8568",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111NR0400X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor, Rehabilitation",
            "state": "IL",
            "license": "038010489",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Rehabilitation Chiropractor in Northbrook, IL
• Providers in Northbrook, IL by specialty
• Rehabilitation Chiropractor in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 15, 2012; 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.