Provider Demographics
NPI:1750954921
Name:RL GROUP LLC
Entity type:Organization
Organization Name:RL GROUP LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:LYNNA
Authorized Official - Middle Name:
Authorized Official - Last Name:FIELDS TYLER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:708-860-1201
Mailing Address - Street 1:1200 W 35TH ST
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60609-1305
Mailing Address - Country:US
Mailing Address - Phone:708-508-9165
Mailing Address - Fax:708-221-6679
Practice Address - Street 1:1200 W 35TH ST
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60609-1305
Practice Address - Country:US
Practice Address - Phone:708-508-9165
Practice Address - Fax:708-221-6679
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-07-23
Last Update Date:2021-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)