LIFE GATE PHARMACY LLC (NPI# 1558788760) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1558788760 |
| Entity Type | Organization |
| Organization Name | LIFE GATE PHARMACY LLC |
| Practice Address |
5241 S Cicero Ave Chicago IL 60632 |
| Mailing Address |
8559 W 121st St Palos Park IL 60464-1230 |
| Practice Telephone | 7085573155 |
| Practice Fax Number | 7732846431 |
| Mailing Telephone | 7085573155 |
| Mailing Fax Number | 7274749067 |
| Enumeration Date | 2014-03-25 |
| Last Update Date | 2018-09-17 |
| Authorized Official Name | MS. MICHELLE HERZOG (OWNER) |
| Authorized Official Telephone | 7085573155 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207P00000X | Emergency Medicine | 036059796 | IL | Allopathic & Osteopathic Physicians |
| Y | 213ES0103X |
Podiatrist Specialization: Foot & Ankle Surgery |
016003225 | IL | Podiatric Medicine & Surgery Service Providers |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 8559 W 121st St, Palos Park, IL 604641230 | 7085573155 | 7274749067 |
| Street Address |
5241 S CICERO AVE |
| City | CHICAGO |
| State | IL |
| Zip Code | 60632 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1417066689 | Matthew George Garoufalis | Podiatrist | 5241 S Cicero Ave, Suite 103, Chicago, IL 60632-4967 | 2006-08-30 |
| 1063028538 | Podiatric Management Systems LLC | Podiatrist | 5241 S Cicero Ave, Chicago, IL 60632-4967 | 2020-09-21 |
| 1750847539 | Vibration Therapy Solutions LLC | Clinic/Center | 5241 S Cicero Ave, Chicago, IL 60632-4967 | 2019-02-15 |
| 1063838522 | Medical and Rehababilitation Center of Chicago LLC | Clinic/Center | 5241 S Cicero Ave, Chicago, IL 60632-4967 | 2014-03-07 |
| 1255606976 | Advanced Neurological Diagnostics, LLC | Clinic/Center | 5241 S Cicero Ave, Suite 201, Chicago, IL 60632-4967 | 2012-03-13 |
| 1801194279 | Sound Sleep | Clinic/Center | 5241 S Cicero Ave, Chicago, IL 60632-4967 | 2011-03-08 |
| 1912201823 | Advanced Neurological Testing Services LLC | Clinic/Center | 5241 S Cicero Ave, Chicago, IL 60632-4967 | 2011-01-06 |
| 1285881003 | Luke Warner Kovatch | Podiatrist | 5241 S Cicero Ave, Ste 103, Chicago, IL 60632-4967 | 2008-08-22 |
| 1649457920 | Pain Management Services Midwest, Ltd. | Chiropractor | 5241 S Cicero Ave, Chicago, IL 60632-4967 | 2008-01-29 |
| 1063615557 | Professional Foot Care Specialists, P.C. | Podiatrist | 5241 S Cicero Ave, Suite 103, Chicago, IL 60632-4967 | 2007-06-11 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1104474790 | Amanda Rose Dirnberger | Nurse Practitioner | 3229-43 W. 47th Pl., Chicago, IL 60632 | 2019-08-28 |
| 1982121042 | Brown Archer Dental PC | Dentist | 4893 S Archer Ave, Chicago, IL 60632 | 2017-08-29 |
| 1538577085 | Metrosmiles - Archer Heights Dental | Dentist | 5141 S Cicero Ave, Chicago, IL 60632 | 2014-07-29 |
| 1174955173 | Thresholds | Community/Behavioral Health | 718-24 West 47th St, Chicago, IL 60632 | 2013-08-01 |
| 1659612570 | Sapex Home Healthcare, Inc. | In Home Supportive Care | 4107 West 47th Street, Chicago, IL 60632 | 2013-03-04 |
| 1912275462 | Dawn Marie Mackessy | Pharmacist | 5435 S. Kedzie Ave, Chicago, IL 60632 | 2011-12-12 |
| 1033494752 | Molly Elizabeth Mcdermott | Pharmacist | District 222-walgreens, Chicago, IL 60632 | 2011-10-13 |
| 1780908434 | Chicago Electrical Trauma Research Institute | Specialist/Technologist, Other | 4047 W. 40th Street, Chicago, IL 60632 | 2010-03-24 |
| 1265765218 | 4365 Archer Mri, LLC | Clinic/Center | 4365 South Archer Avenue, Chicago, IL 60632 | 2009-09-09 |
| 1295968121 | Smile Lee Faces | Dentist | 4197 S Archer Ave, Chicago, IL 60632 | 2009-08-26 |
| Find all providers in zip 60632 | ||||
| Taxonomy Code | 213ES0103X |
| Grouping | Podiatric Medicine & Surgery Service Providers |
| Classification | Podiatrist |
| Specialization | Foot & Ankle Surgery |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1821631367 | Dr Christine Heck PC | Podiatrist | 111 N Wabash Ave Ste 1914, Chicago, IL 60602-2968 | 2019-10-28 |
| 1013562578 | Bishoy Atef Botros | Podiatrist | 820 S Damen Ave Fl 7, Chicago, IL 60612-3728 | 2019-08-01 |
| 1346752656 | Prairie Foot & Ankle, P.C. | Podiatrist | 7447 West Talcott Ave, Suite 406, Chicago, IL 60163-3275 | 2017-10-26 |
| 1558886549 | Castle Podiatry, LLC | Podiatrist | 11628 S Western Ave, Chicago, IL 60643-4730 | 2017-08-10 |
| 1669854089 | Adam Shapiro | Podiatrist | 3710 N Pine Grove Ave, Chicago, IL 60613-4186 | 2015-06-22 |
| 1891103925 | Nathan Kramer | Podiatrist | 320 S Ashland Ave Ste 2, Chicago, IL 60607-2856 | 2014-08-01 |
| 1700292711 | Archer Foot Clinic | Podiatrist | 3113 S Archer Ave, Chicago, IL 60608-6223 | 2014-07-10 |
| 1871909382 | Rashad Sayeed | Podiatrist | 4646 N. Marine Drive, Chicago, IL 60640-0000 | 2014-07-03 |
| 1275964918 | Aleksandr Komarov Dpm LLC | Podiatrist | 1360 N Lake Shore Dr Apt 708, Chicago, IL 60610-8442 | 2013-12-05 |
| 1568895043 | Allison Rottman | Podiatrist | 4734 N Beacon St, 2w, Chicago, IL 60640-4847 | 2013-08-19 |
| Find all providers in CHICAGO | ||||
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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.