Provider Demographics
NPI:1275949877
Name:LAKEVIEW LIFE RISING
Entity Type:Organization
Organization Name:LAKEVIEW LIFE RISING
Other - Org Name:SHEN SHEN HEALTH AND HARMONY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:
Authorized Official - Last Name:JONES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:773-935-4325
Mailing Address - Street 1:2764 N LINCOLN AVE
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60614-6810
Mailing Address - Country:US
Mailing Address - Phone:773-935-4325
Mailing Address - Fax:
Practice Address - Street 1:2764 N LINCOLN AVE
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60614-6810
Practice Address - Country:US
Practice Address - Phone:773-935-4325
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-07-03
Last Update Date:2014-07-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL198-000507171100000X
IL198-000289171100000X
IL198-000618171100000X
IL198-001140171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171100000XOther Service ProvidersAcupuncturistGroup - Multi-Specialty