Healthcare Provider Details

I. General information

NPI: 1154244655
Provider Name (Legal Business Name): FAITH FAMILY LIFE INTERNATIONAL
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/01/2026
Last Update Date: 08/01/2026
Certification Date: 08/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3521 173RD ST
LANSING IL
60438-1480
US

IV. Provider business mailing address

3521 173RD ST
LANSING IL
60438-1480
US

V. Phone/Fax

Practice location:
  • Phone: 708-510-7288
  • Fax:
Mailing address:
  • Phone: 708-510-7288
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code251K00000X
TaxonomyPublic Health or Welfare Agency
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code251V00000X
TaxonomyVoluntary or Charitable Agency
License Number
License Number State

VIII. Authorized Official

Name: INYE SUNJU HART
Title or Position: PRESIDENT/CEO
Credential:
Phone: 708-510-7288