Healthcare Provider Details

I. General information

NPI: 1518870369
Provider Name (Legal Business Name): THRIVE INTEGRATIVE HEALTHCARE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/23/2026
Last Update Date: 09/23/2026
Certification Date: 09/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8204 S STONY ISLAND AVE
CHICAGO IL
60617-1750
US

IV. Provider business mailing address

8204 S STONY ISLAND AVE
CHICAGO IL
60617-1750
US

V. Phone/Fax

Practice location:
  • Phone: 773-931-1769
  • Fax:
Mailing address:
  • Phone: 773-931-1769
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number State

VIII. Authorized Official

Name: OLAMIDE TUNDE-ALI
Title or Position: CLINICAL DIRECTIR
Credential: LCPC
Phone: 773-931-1769