Provider Demographics
NPI:1720462799
Name:LIFE SOLUTIONS: INTEGRATIVE HEALING & WELL BEING LLC
Entity Type:Organization
Organization Name:LIFE SOLUTIONS: INTEGRATIVE HEALING & WELL BEING LLC
Other - Org Name:LIFE SOLUTIONS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:MARGO
Authorized Official - Middle Name:
Authorized Official - Last Name:MILANO
Authorized Official - Suffix:
Authorized Official - Credentials:PHD, LCPC, CFLE, NCC
Authorized Official - Phone:779-201-8006
Mailing Address - Street 1:1500 E. LINCOLN HWY STE 1
Mailing Address - Street 2:1500
Mailing Address - City:DEKALB
Mailing Address - State:IL
Mailing Address - Zip Code:60115
Mailing Address - Country:US
Mailing Address - Phone:779-201-8006
Mailing Address - Fax:779-256-0204
Practice Address - Street 1:1500 E LINCOLN HWY STE 1
Practice Address - Street 2:
Practice Address - City:DEKALB
Practice Address - State:IL
Practice Address - Zip Code:60115-3990
Practice Address - Country:US
Practice Address - Phone:779-777-7933
Practice Address - Fax:630-566-3323
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-07-19
Last Update Date:2022-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL180.006446101YM0800X, 101YP2500X, 251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes251S00000XAgenciesCommunity/Behavioral Health
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL1609117019OtherNPI