Provider Demographics
NPI:1114319043
Name:LIFELINE BEHAVIORAL HEALTHCARE LTD.
Entity Type:Organization
Organization Name:LIFELINE BEHAVIORAL HEALTHCARE LTD.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MS
Authorized Official - First Name:SHERYL
Authorized Official - Middle Name:L
Authorized Official - Last Name:ANKROM
Authorized Official - Suffix:
Authorized Official - Credentials:LCPC
Authorized Official - Phone:708-606-1334
Mailing Address - Street 1:18301 DISTINCTIVE DR
Mailing Address - Street 2:
Mailing Address - City:ORLAND PARK
Mailing Address - State:IL
Mailing Address - Zip Code:60467-9461
Mailing Address - Country:US
Mailing Address - Phone:708-928-5700
Mailing Address - Fax:708-570-1617
Practice Address - Street 1:18301 DISTINCTIVE DR
Practice Address - Street 2:
Practice Address - City:ORLAND PARK
Practice Address - State:IL
Practice Address - Zip Code:60467-9461
Practice Address - Country:US
Practice Address - Phone:708-928-5700
Practice Address - Fax:708-570-1617
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-03-02
Last Update Date:2024-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL180007337101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty