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General NPI Number Information
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NPI Number | 1932784006
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Entity Type | Organization
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Legal Business Name | LIFESAVER HEALTHCARE, LLC
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Dates
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Enumeration Date | 03/10/2021
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Last Update Date | 03/10/2021
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Provider Practice Location Address
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Address Line | 7929 S YATES BLVD SUITE 201
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City | CHICAGO
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State | IL
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Zip | 60617
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Country | US
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Telephone | 877-799-7412
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Fax | 773-922-0178
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Provider Business Mailing Address
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Address Line | 7929 S YATES BLVD SUITE 201
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City | CHICAGO
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State | IL
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Zip | 60617
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Country | US
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Telephone | 773-552-2465
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Fax | 773-922-0178
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Authorized Official
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Title or Position | NURSE PRACTITIONER
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Name | BRANDY LYNN HANSON
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Credential | APRN
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Telephone | 773-552-2465
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 291U00000X
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Taxonomy Name | Clinical Medical Laboratory
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 261QM1300X
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Taxonomy Name | Multi-Specialty Clinic/Center
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License Number |
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License Number State |
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