Provider Demographics
NPI:1184221004
Name:LIVE IGNITE THRIVE LIMITED
Entity type:Organization
Organization Name:LIVE IGNITE THRIVE LIMITED
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:ADAM
Authorized Official - Middle Name:
Authorized Official - Last Name:WELDZIUS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:847-452-6533
Mailing Address - Street 1:2345 E OFFNER RD
Mailing Address - Street 2:
Mailing Address - City:BEECHER
Mailing Address - State:IL
Mailing Address - Zip Code:60401-3784
Mailing Address - Country:US
Mailing Address - Phone:847-452-6533
Mailing Address - Fax:
Practice Address - Street 1:15614 S HARLEM AVE STE C
Practice Address - Street 2:
Practice Address - City:ORLAND PARK
Practice Address - State:IL
Practice Address - Zip Code:60462-4401
Practice Address - Country:US
Practice Address - Phone:708-866-5900
Practice Address - Fax:708-866-5903
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-10-04
Last Update Date:2021-09-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM1300XAmbulatory Health Care FacilitiesClinic/CenterMulti-Specialty