Eagle Healthy Living Inc

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

209011607 Issued in IL

Legal business name

EAGLE HEALTHY LIVING INC

Practice address

16057 School St
South Holland, IL 60473-1630

Phone

(708) 692-2903

NPI assigned

Jul 1, 2015

Organization subpart

No

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

Authorized official

Name

William Bryant

Title

Director of Clinical Operations

Phone

(708) 692-2903

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1435708800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1469145600000",
    "number": "1801279344",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16057 SCHOOL ST",
            "city": "SOUTH HOLLAND",
            "state": "IL",
            "postal_code": "604731630"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16057 SCHOOL ST",
            "city": "SOUTH HOLLAND",
            "state": "IL",
            "postal_code": "604731630",
            "telephone_number": "708-692-2903"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EAGLE HEALTHY LIVING INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-07-01",
        "last_updated": "2016-07-22",
        "status": "A",
        "authorized_official_last_name": "BRYANT",
        "authorized_official_first_name": "WILLIAM",
        "authorized_official_title_or_position": "DIRECTOR OF CLINICAL OPERATIONS",
        "authorized_official_telephone_number": "708-692-2903"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": "IL",
            "license": "209011607",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Dr Walter B Busse &Associates LTD
• Dr. Stephen Shulman, P.C.
• Addoria Driver, MFT
• Shweta Singh Duggal, MBBS
• Eagle Healthy Living Inc
• Julia Ifeoma Egbuna
• Elevate Care South Holland LLC
• Elevate Care South Holland LLC
• Elite Care Dental, P.C.
• Douglas K Elliott, PT

• Family Medicine Physician in South Holland, IL
• Providers in South Holland, IL by specialty
• Family Medicine Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 22, 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.