# LIFE FORWARD THERAPY

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1407650328
- **Authorized official:** CAROLINE BURKE (OWNER)
- **Authorized official phone:** (847) 420-3256

## Contact information

- **Practice address:** 3502 N WILTON AVE \# 1, CHICAGO, IL 60657-1742
- **Practice address phone:** (847) 420-3256
- **Mailing address:** 1728 N WOOD ST APT 1F, CHICAGO, IL 60622-1359
- **Mailing address phone:** (847) 420-3256

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261Q00000X | Clinic/Center | — | NULL | Yes |

## Other

- **Enumeration date:** 04/01/2025
- **Last updated:** 10/08/2025