Healthcare Provider Details

I. General information

NPI: 1932723517
Provider Name (Legal Business Name): SENIOR LIFESTYLE SOLUTIONS, LTD.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/30/2020
Last Update Date: 02/24/2025
Certification Date: 02/24/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

282 MEMORIAL CT STE A
CRYSTAL LAKE IL
60014-6277
US

IV. Provider business mailing address

282 MEMORIAL CT STE A
CRYSTAL LAKE IL
60014-6277
US

V. Phone/Fax

Practice location:
  • Phone: 815-354-8977
  • Fax: 815-893-0663
Mailing address:
  • Phone: 815-354-8977
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State

VIII. Authorized Official

Name: MRS. LAURIE ANN TEATOR
Title or Position: OWNER
Credential:
Phone: 815-354-8977