Provider Demographics
NPI:1932266194
Name:LIFETEC, INC.
Entity Type:Organization
Organization Name:LIFETEC, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:J
Authorized Official - Last Name:CHRISTOI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:847-459-7500
Mailing Address - Street 1:1710 S WOLF RD
Mailing Address - Street 2:
Mailing Address - City:WHEELING
Mailing Address - State:IL
Mailing Address - Zip Code:60090-6517
Mailing Address - Country:US
Mailing Address - Phone:847-459-7500
Mailing Address - Fax:847-459-1916
Practice Address - Street 1:1710 S WOLF RD
Practice Address - Street 2:
Practice Address - City:WHEELING
Practice Address - State:IL
Practice Address - Zip Code:60090-6517
Practice Address - Country:US
Practice Address - Phone:847-459-7500
Practice Address - Fax:847-459-1916
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-03
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Not Answered332BC3200XSuppliersDurable Medical Equipment & Medical SuppliesCustomized Equipment
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL01633955OtherDME