NPI Code Details Logo

NPI 1992399323

NPI 1992399323 : LIFESAVER HEALTHCARE, LLC : CHICAGO, IL

=====================================================
General NPI Number Information
=====================================================
    NPI Number           |    1992399323
-----------------------------------------------------
    Entity Type          |    Organization 
-----------------------------------------------------
    Legal Business Name  |    LIFESAVER HEALTHCARE, LLC 
-----------------------------------------------------

=====================================================
Dates
=====================================================
    Enumeration Date     |    02/25/2021
-----------------------------------------------------
    Last Update Date     |    02/25/2021
-----------------------------------------------------

=====================================================
Provider Practice Location Address
=====================================================
    Address Line         |    7933 S YATES BLVD STE 201 
-----------------------------------------------------
    City                 |    CHICAGO
-----------------------------------------------------
    State                |    IL
-----------------------------------------------------
    Zip                  |    60617-1102
-----------------------------------------------------
    Country              |    US
-----------------------------------------------------
    Telephone            |    877-799-7412
-----------------------------------------------------
    Fax                  |    773-922-0178
-----------------------------------------------------

=====================================================
Provider Business Mailing Address
=====================================================
    Address Line         |    7933 S YATES BLVD STE 201 
-----------------------------------------------------
    City                 |    CHICAGO
-----------------------------------------------------
    State                |    IL
-----------------------------------------------------
    Zip                  |    60617-1102
-----------------------------------------------------
    Country              |    US
-----------------------------------------------------
    Telephone            |    877-799-7412
-----------------------------------------------------
    Fax                  |    773-922-0178
-----------------------------------------------------

=====================================================
Authorized Official
=====================================================
    Title or Position    |    OWNER
-----------------------------------------------------
    Name                 |     BRANDY LYNN HANSON 
-----------------------------------------------------
    Credential           |    
-----------------------------------------------------
    Telephone            |    773-552-2465
-----------------------------------------------------

=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
    Taxonomy Code        |    363L00000X
-----------------------------------------------------
    Taxonomy Name        |    Nurse Practitioner
-----------------------------------------------------
    License Number       |    
-----------------------------------------------------
    License Number State |    
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
    Taxonomy Code        |    261QM1300X
-----------------------------------------------------
    Taxonomy Name        |    Multi-Specialty Clinic/Center
-----------------------------------------------------
    License Number       |    
-----------------------------------------------------
    License Number State |    
-----------------------------------------------------



                        

Copyright © 2007-2026 Data Labs Health. All rights reserved.