Provider Demographics
NPI:1205346319
Name:LIFELINE CONCORD LLC
Entity type:Organization
Organization Name:LIFELINE CONCORD LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:J
Authorized Official - Last Name:HERLIHY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:847-933-9348
Mailing Address - Street 1:3737 CHASE AVE
Mailing Address - Street 2:
Mailing Address - City:SKOKIE
Mailing Address - State:IL
Mailing Address - Zip Code:60076-4008
Mailing Address - Country:US
Mailing Address - Phone:847-933-9348
Mailing Address - Fax:847-933-9319
Practice Address - Street 1:1340 JOHN A PAPALAS DR
Practice Address - Street 2:
Practice Address - City:LINCOLN PARK
Practice Address - State:MI
Practice Address - Zip Code:48146-1356
Practice Address - Country:US
Practice Address - Phone:313-386-9400
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-10-03
Last Update Date:2022-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes341600000XTransportation ServicesAmbulance