Provider Demographics
NPI:1013268176
Name:LUMEN HEALING CENTER, INC
Entity type:Organization
Organization Name:LUMEN HEALING CENTER, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:SONIA
Authorized Official - Middle Name:ANGELICA
Authorized Official - Last Name:SALINAS
Authorized Official - Suffix:
Authorized Official - Credentials:P T
Authorized Official - Phone:312-804-5655
Mailing Address - Street 1:5420 N SHERIDAN RD
Mailing Address - Street 2:SUITE 205
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60640-1956
Mailing Address - Country:US
Mailing Address - Phone:312-804-5655
Mailing Address - Fax:773-944-1048
Practice Address - Street 1:5420 N SHERIDAN RD
Practice Address - Street 2:SUITE 205
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60640-1956
Practice Address - Country:US
Practice Address - Phone:312-804-5655
Practice Address - Fax:773-944-1048
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-09-28
Last Update Date:2012-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy