MEDICARE: LIFE SOLUTIONS HEALTH

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207Q00000X	Family Medicine Physician

General Provider Information

NPI Number	:	1396678637
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	LIFE SOLUTIONS HEALTH

Provider Business Mailing Address
First Line	:	PO BOX 5367
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60680-5367
Country	:	US
Telephone Number	:	773-936-9661
Fax Number	:

Provider Business Practice Location Address
First Line	:	6534 S GREENWOOD AVE
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60637-4314
Country	:	US
Telephone Number	:	773-858-8185
Fax Number	:

Authorized Official
Title or Position	:	CEO
Name	:	DR. TRACIE E CLISBY
Credential	:	APN
Telephone Number	:	773-858-8185

Provider Enumeration Date	:	06/05/2026
Last Update Date	:	06/10/2026

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Directions to “LIFE SOLUTIONS HEALTH ” Practice Location

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