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General NPI Number Information
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NPI Number | 1952241580
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Entity Type | Organization
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Legal Business Name | INTRINSIC INTEGRATED LIVING
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Dates
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Enumeration Date | 03/31/2026
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Last Update Date | 03/31/2026
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Provider Practice Location Address
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Address Line | 333 E 35TH ST
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City | CHICAGO
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State | IL
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Zip | 60616-3951
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Country | US
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Telephone | 312-967-3177
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Fax | 312-924-0669
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Provider Business Mailing Address
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Address Line | 8700 S DANTE AVE
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City | CHICAGO
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State | IL
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Zip | 60619-7118
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Country | US
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Telephone | 312-967-3177
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Fax | 312-924-0669
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Authorized Official
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Title or Position | CEO
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Name | DR. JASMINE C BANKHEAD
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Credential | RN
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Telephone | 773-606-8002
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251B00000X
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Taxonomy Name | Case Management Agency
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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 | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number |
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License Number State |
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