=====================================================
General NPI Number Information
=====================================================
NPI Number | 1730038233
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | RECLAIM VITALITY LLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 01/27/2026
-----------------------------------------------------
Last Update Date | 01/27/2026
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 19730 GOVERNORS HWY STE 2
-----------------------------------------------------
City | FLOSSMOOR
-----------------------------------------------------
State | IL
-----------------------------------------------------
Zip | 60422-2083
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 708-794-8312
-----------------------------------------------------
Fax | 708-816-5587
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 2501 CHATHAM RD STE N
-----------------------------------------------------
City | SPRINGFIELD
-----------------------------------------------------
State | IL
-----------------------------------------------------
Zip | 62704-4188
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 708-794-8312
-----------------------------------------------------
Fax | 708-816-5587
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | OWNER/MASSAGE THERAPIST
-----------------------------------------------------
Name | LAURA E PAGEL-STRATON
-----------------------------------------------------
Credential | LMT
-----------------------------------------------------
Telephone | 708-794-8312
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 225700000X
-----------------------------------------------------
Taxonomy Name | Massage Therapist
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------