CHICAGO AGE MANAGEMENT INSTITUTE (NPI# 1083052609) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1083052609 |
| Entity Type | Organization |
| Organization Name | CHICAGO AGE MANAGEMENT INSTITUTE |
| Other Organization Name | LIFEFORCE MEDICAL INSTITUTE |
| Practice Address |
60 Revere Dr Ste 820 Northbrook IL 60062-1580 |
| Practice Telephone | 8479059505 |
| Practice Fax Number | 8479057344 |
| Mailing Telephone | 8479059505 |
| Mailing Fax Number | 8479057344 |
| Enumeration Date | 2013-06-05 |
| Last Update Date | 2013-06-05 |
| Authorized Official Name | MRAK ROSENBLOOM (CHIEF MEDICAL OFFICER, CEO) |
| Authorized Official Telephone | 8479059505 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2083P0901X |
Preventive Medicine Specialization: Public Health & General Preventive Medicine |
Allopathic & Osteopathic Physicians |
| Other Name | Type Code |
|---|---|
| LIFEFORCE Medical Institute | Doing Business As Name - Organization |
| Street Address |
60 REVERE DR STE 820 |
| City | NORTHBROOK |
| State | IL |
| Zip Code | 60062-1580 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1508487067 | Cvs Aoc Services, L.L.C. | Optometrist | 936 Willow Road, Store 0141, Northbrook, IL 60062 | 2020-05-06 |
| 1386103885 | Jennifer Venegas | Behavior Technician | 5 Revere Dr Suit 120, Northbrook, IL 60062 | 2019-03-14 |
| 1720558281 | Taylor Hundley | Behavior Technician | 5 Revere Dr. Suite 120, Northbrook, IL 60062 | 2018-11-27 |
| 1609344027 | Melissa Cepeda | Behavior Technician | 5 Revere Dr Suite 120, Northbrook, IL 60062 | 2018-11-03 |
| 1235606658 | Candace Cheyenne Kaiser | Behavior Technician | 5 Revere Dr, Suite 120, Northbrook, IL 60062 | 2018-10-24 |
| 1275058745 | The Renfrew Center of Illinois | Counselor | 5 Revere Dr, Suite 100, Northbrook, IL 60062 | 2017-08-07 |
| 1467984773 | Ayzenshteyn Chiropractic | Chiropractor | 3210 Doolittle Dr., Northbrook, IL 60062 | 2017-03-28 |
| 1396282695 | Josephine Driscoll | Physician Assistant | 400 Skokie Blvd., Suite 450, Northbrook, IL 60062 | 2017-01-24 |
| 1396297842 | Lauren Raphael Lcsw LLC | Social Worker | 3050 Pheasant Creek Drive, Apt. 104, Northbrook, IL 60062 | 2016-11-01 |
| 1851847073 | Jassim Vailoces | Physical Therapist | 634 Academy Dr, Northbrook, IL 60062 | 2016-08-28 |
| Find all providers in zip 60062 | ||||
| Taxonomy Code | 2083P0901X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Preventive Medicine |
| Specialization | Public Health & General Preventive Medicine |
| Public health and general preventive medicine focuses on promoting health, preventing disease, and managing the health of communities and defined populations. These practitioners combine population-based public health skills with knowledge of primary, secondary, and tertiary prevention-oriented clinical practice in a wide variety of settings. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Preventive Medicine, 2007. http://www.abprevmed.org/. American Osteopathic Board of Preventive Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Preventive Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Preventive Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1588078844 | Lifeforce Medical Institute | Preventive Medicine | 60 Revere Dr, Site 820, Northbrook, IL 60062-1563 | 2014-06-16 |
| 1003122730 | Mark Rosenbloom | Preventive Medicine | 60 Revere Dr, Suite 820, Northbrook, IL 60062-1563 | 2010-08-18 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1275022188 | Vip Health and Fitness Clinic | Preventive Medicine | 100 N Fairway Dr Ste 100-102, Vernon Hills, IL 60061-1859 | 2018-05-07 |
| 1457776361 | Caroline Marie Jung | Preventive Medicine | 1817 W Berwyn Ave # 3, Chicago, IL 60640-1005 | 2014-02-28 |
| 1568690899 | Sargon Audisho | Preventive Medicine | 4143 N Claremont Ave, Apt 2, Chicago, IL 60618-2919 | 2009-06-25 |
| 1194910125 | Chicago Dept of Public Health | Preventive Medicine | 2849 N Clark St, Lakeview N H C, Chicago, IL 60657 | 2007-09-12 |
| 1508071010 | Violeta P Dulanas | Preventive Medicine | 4958 W Madison St, Chicago, IL 60644-3541 | 2007-05-10 |
| 1073727400 | Lourdes Mella Hilao | Preventive Medicine | 4243 W Fullerton Ave, Chicago, IL 60639-2049 | 2007-05-08 |
| 1639395239 | K Michael Lipkin | Preventive Medicine | 370 Aspen Ln, Highland Park, IL 60035-4525 | 2007-04-18 |
| 1457493546 | Esperanza G Salvador | Preventive Medicine | 2100 Ridge Ave, Evanston, IL 60201-2716 | 2007-02-13 |
| 1518021153 | Westside C.d.c | Preventive Medicine | 2160 W. Ogden, Westside C.d.c, Chicago, IL 60604 | 2006-12-20 |
| 1821159625 | 31st Std Clinic | Preventive Medicine | 530 E 31st St, Std 31st Street Clinic, Chicago, IL 60616-4008 | 2006-12-13 |
| Find all providers with the same taxonomy | ||||
| City | NORTHBROOK |
| Zip Code | 60062 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.