Provider Demographics
NPI:1518180892
Name:HEALTHY LIVING INTERNATIONAL
Entity Type:Organization
Organization Name:HEALTHY LIVING INTERNATIONAL
Other - Org Name:BLOOMINGDALE COUNSELING SERVICES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER AND DIRECTOR
Authorized Official - Prefix:MISS
Authorized Official - First Name:PATRICIA
Authorized Official - Middle Name:
Authorized Official - Last Name:SCOTT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:630-894-4451
Mailing Address - Street 1:148 S BLOOMINGDALE RD
Mailing Address - Street 2:
Mailing Address - City:BLOOMINGDALE
Mailing Address - State:IL
Mailing Address - Zip Code:60108-1492
Mailing Address - Country:US
Mailing Address - Phone:630-894-4451
Mailing Address - Fax:630-894-2876
Practice Address - Street 1:148 S BLOOMINGDALE RD
Practice Address - Street 2:SUITE 112
Practice Address - City:BLOOMINGDALE
Practice Address - State:IL
Practice Address - Zip Code:60108-1492
Practice Address - Country:US
Practice Address - Phone:630-894-4451
Practice Address - Fax:630-894-2876
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-11
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL02221520OtherBCBS