1164605424 NPI number — INSPIRED LIVING INC

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1164605424 NPI number — INSPIRED LIVING INC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
INSPIRED LIVING INC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1164605424
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
07/03/2008
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1033 DEERFIELD RD
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
DEERFIELD
Provider Business Mailing Address State Name:
IL
Provider Business Mailing Address Postal Code:
60015-4125
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
847-945-2369
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
100 VILLAGE GREEN DR
Provider Second Line Business Practice Location Address:
SUITE 220
Provider Business Practice Location Address City Name:
LINCOLNSHIRE
Provider Business Practice Location Address State Name:
IL
Provider Business Practice Location Address Postal Code:
60069
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
847-415-5077
Provider Business Practice Location Address Fax Number:
847-793-8892
Provider Enumeration Date:
12/10/2007

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
CHAPUT
Authorized Official First Name:
DIANE
Authorized Official Middle Name:
Authorized Official Title or Position:
PRESIDENT
Authorized Official Telephone Number:
847-945-2369

Provider Taxonomy Codes

  • Taxonomy code: 101YA0400X , with the licence number:  180006669 , registered in the state of IL ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 101YM0800X , with the licence number: 180006669 , registered in the state of IL ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 101YP2500X , with the licence number: 180006669 , registered in the state of IL ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)