Provider Demographics
NPI:1376178962
Name:LIVESTRONG THERAPY LLC
Entity Type:Organization
Organization Name:LIVESTRONG THERAPY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:AUTHORIZED OFFICIAL
Authorized Official - Prefix:
Authorized Official - First Name:CHRISTI
Authorized Official - Middle Name:
Authorized Official - Last Name:LIVINGSTONE
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:773-459-6714
Mailing Address - Street 1:2772 NORTHERN LIGHTS WAY
Mailing Address - Street 2:
Mailing Address - City:NEW LENOX
Mailing Address - State:IL
Mailing Address - Zip Code:60451-7503
Mailing Address - Country:US
Mailing Address - Phone:708-400-8063
Mailing Address - Fax:708-400-8706
Practice Address - Street 1:2772 NORTHERN LIGHTS WAY
Practice Address - Street 2:
Practice Address - City:NEW LENOX
Practice Address - State:IL
Practice Address - Zip Code:60451-7503
Practice Address - Country:US
Practice Address - Phone:708-400-8063
Practice Address - Fax:708-400-8706
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-03-04
Last Update Date:2022-06-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty
No225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Multi-Specialty
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGroup - Multi-Specialty