LIFE GATE PHARMACY LLC NPI 1558788760

NPI Information

NPI: 1558788760
Provider Name: LIFE GATE PHARMACY LLC
Classification: Podiatrist - 213ES0103X
Entity Type: Organization

Specialization: Foot & Ankle Surgery

Address:
5241 S CICERO AVE
CHICAGO, IL
ZIP 60632
Phone: (708) 557-3155
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LIFE GATE PHARMACY LLC is a foot and ankle surgery podiatrist in Chicago, IL. LIFE GATE PHARMACY LLC NPI is 1558788760. The provider is registered as an organization entity type and is a multiple single specialty group.

The provider's business location address is:

5241 S CICERO AVE
CHICAGO, IL
ZIP 60632
Phone: (708) 557-3155
Fax: (773) 284-6431

The provider's authorized official is Michelle Herzog .
The authorized official title is Owner and has the following contact phone number (708) 557-3155.

The enumeration date for this NPI number is 3/25/2014 and was last updated on 9/17/2018.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	207P00000X	Emergency Medicine		036059796	ILLINOIS	No
2	213ES0103X	Podiatrist	Foot & Ankle Surgery	016003225	ILLINOIS	Yes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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