NPIMap

Organization Active NPI

Lifelong Access

  • Speech-Language Pathologist
  • Normal, IL
National Provider Identifier
1891701389
Registry record updated Aug 27, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
Legal business name
LIFELONG ACCESS
Practice address
2000 Jacobssen Dr
Normal, IL 61761-6277
Phone
(309) 451-8888
Fax
(309) 451-8989
NPI assigned
Aug 1, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 27, 2024

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

Authorized official

Name
Patrick Dyce Bailey
Title
Program Supports Advisor
Phone
(309) 451-8888

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior AnalystGroup: 193200000X MULTI-SPECIALTY GROUP 103K00000X
Physical TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 225100000X
Occupational TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 225X00000X
Speech-Language PathologistGroup: 193200000X MULTI-SPECIALTY GROUP 235Z00000X Primary

Addresses

Primary practice location

2000 Jacobssen Dr
Normal, IL 61761-6277

Mailing address

2000 Jacobssen Dr
Normal, IL 61761-6277
Phone (309) 451-8888

Other names 2

  • Marc Doing business as
  • Marcfirst Former legal business name

National Provider Directory

National Provider Directory
Tax ID family
Lifelong Access3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

Practitioners & affiliated clinicians

Practitioners 5

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": "1154390400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1724716800000",
    "number": "1891701389",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2000 JACOBSSEN DR",
            "city": "NORMAL",
            "state": "IL",
            "postal_code": "617616277",
            "telephone_number": "309-451-8888",
            "fax_number": "309-451-8989"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2000 JACOBSSEN DR",
            "city": "NORMAL",
            "state": "IL",
            "postal_code": "617616277",
            "telephone_number": "309-451-8888",
            "fax_number": "309-451-8989"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIFELONG ACCESS",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-01",
        "last_updated": "2024-08-27",
        "certification_date": "2024-08-27",
        "status": "A",
        "authorized_official_last_name": "BAILEY",
        "authorized_official_first_name": "PATRICK",
        "authorized_official_middle_name": "DYCE",
        "authorized_official_title_or_position": "PROGRAM SUPPORTS ADVISOR",
        "authorized_official_telephone_number": "309-451-8888"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Behavior Analyst",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Occupational Therapist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Speech-Language Pathologist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Marc",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Marc",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Marcfirst",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

Other providers in Normal, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 27, 2024; 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.