Healthcare Provider Details

I. General information

NPI: 1801702451
Provider Name (Legal Business Name): FANCY SHMANCY ANALYZE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/24/2026
Last Update Date: 08/24/2026
Certification Date: 08/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1770 1ST ST STE 204
HIGHLAND PARK IL
60035-3229
US

IV. Provider business mailing address

1770 1ST ST STE 204
HIGHLAND PARK IL
60035-3229
US

V. Phone/Fax

Practice location:
  • Phone: 224-432-7454
  • Fax:
Mailing address:
  • Phone: 224-432-7454
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261Q00000X
TaxonomyClinic/Center
License Number
License Number State

VIII. Authorized Official

Name: LIANA REZNIK
Title or Position: OWNER
Credential:
Phone: 312-972-0152