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ACTIVE LIFE INSTITUTE NPI 1932244423


NPI Information

NPI: 1932244423
Provider Name: ACTIVE LIFE INSTITUTE
Classification: Chiropractor - 111N00000X
Entity Type: Organization
Address:
304 E OGDEN AVE
NAPERVILLE, IL
ZIP 60563
Phone: (630) 717-8575
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ACTIVE LIFE INSTITUTE is a chiropractor in Naperville, IL. The provider is a provider qualified by a Doctor of Chiropractic (D.C.), licensed by the State and who practices chiropractic medicine -that discipline within the healing arts which deals with the nervous system and its relationship to the spinal column and its interrelationship with other body systems. ACTIVE LIFE INSTITUTE NPI is 1932244423. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

304 E OGDEN AVE
NAPERVILLE, IL
ZIP 60563-159
Phone: (630) 717-8575
Fax: (630) 717-8573

The provider's authorized official is David Mark Prator .
The authorized official title is Institute Director and has the following contact phone number (630) 717-8575.

The enumeration date for this NPI number is 2/21/2007 and was last updated on 8/22/2020.


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 CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1111N00000XChiropractorILLINOISYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
102232434OTHERILLINOISBCBS
2DB0886OTHERILLINOISRAILROAD #
3P00086076OTHERILLINOISUPIN RAILROAD MEDICARE
47268512OTHERILLINOISMEDICARE MANAGE CARE #

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

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