Healthcare Provider Details

I. General information

NPI: 1457278947
Provider Name (Legal Business Name): LIONIZE COMMUNITY WELLNESS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/04/2026
Last Update Date: 07/04/2026
Certification Date: 07/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1556 ASHLAND AVE
EVANSTON IL
60201-4070
US

IV. Provider business mailing address

1556 ASHLAND AVE
EVANSTON IL
60201-4070
US

V. Phone/Fax

Practice location:
  • Phone: 224-587-6752
  • Fax:
Mailing address:
  • Phone: 224-587-6752
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QP2000X
TaxonomyPhysical Therapy Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: KYLE HUNTER MURRAY
Title or Position: PHYSICAL THERAPIST, DOCTORATE OF PT
Credential: DPT
Phone: 224-587-6752