Lifestyle Rejuvenation Medical Group Pllc

LBN: Lifestyle Rejuvenation Medical Group Pllc
Lifestyle Rejuvenation Medical Group Pllc is an health care organization with primary practice located at 1740 E 55Th Street , Chicago IL 60615. The organization recently has 15 registered licenses in different health care specialties including Chiropractic Providers / Chiropractor, Chiropractic Providers / Rehabilitation, Ambulatory Health Care Facilities / Health Service, Ambulatory Health Care Facilities / Multi-Specialty, Ambulatory Health Care Facilities / Medical Specialty, Ambulatory Health Care Facilities / Physical Therapy, Ambulatory Health Care Facilities / Primary Care, Ambulatory Health Care Facilities / Pain, Ambulatory Health Care Facilities / Radiology, Ambulatory Health Care Facilities / Rehabilitation, Ambulatory Health Care Facilities / Recovery Care, Managed Care Organizations / Health Maintenance Organization, Managed Care Organizations / Preferred Provider Organization, Managed Care Organizations / Point of Service, Suppliers / Durable Medical Equipment & Medical Supplies. Ambulatory Health Care Facilities / Multi-Specialty is the primary health care specialty. Lifestyle Rejuvenation Medical Group Pllc can be contacted via phone (773) 667-9053, or through Higginbottom, Robert Van via phone (773) 667-9053.

Contact Information

Primary practice address
1740 E 55Th Street Chicago IL 60615
Phone: (773) 667-9053
Fax:
Website:
Map and Directions
Authorized official contact:
Name: Higginbottom, Robert Van Doctor of Chiropractic (DC)
Phone: (773) 667-9053

Health care specialties

SpecialtyCodeLicense #State
Chiropractic Providers / Chiropractor 111N00000X
Chiropractic Providers / Rehabilitation 111NR0400X
Ambulatory Health Care Facilities / Health Service 261QH0100X
Ambulatory Health Care Facilities / Multi-Specialty 261QM1300X
Ambulatory Health Care Facilities / Medical Specialty 261QM2500X
Ambulatory Health Care Facilities / Physical Therapy 261QP2000X
Ambulatory Health Care Facilities / Primary Care 261QP2300X
Ambulatory Health Care Facilities / Pain 261QP3300X
Ambulatory Health Care Facilities / Radiology 261QR0200X
Ambulatory Health Care Facilities / Rehabilitation 261QR0400X
Ambulatory Health Care Facilities / Recovery Care 261QR0800X
Managed Care Organizations / Health Maintenance Organization 302R00000X
Managed Care Organizations / Preferred Provider Organization 305R00000X
Managed Care Organizations / Point of Service 305S00000X
Suppliers / Durable Medical Equipment & Medical Supplies 332B00000X

Profile Details

NPI number 1134781974
LBN Legal business name Lifestyle Rejuvenation Medical Group Pllc
DBA Doing business as
Authorized official Higginbottom, Robert Van Doctor of Chiropractic (DC)
Entity Organization
Organization subpart 1 No
Enumeration date Jul 2nd, 2019
Last updated May 29th, 2020 - about 5 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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