Organization
ACTIVE HEALTH CENTERS, LTD.
Active
Organization
ACTIVE HEALTH CENTERS, LTD.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. LESLIE BULYAKI D.C. (PRESIDENT)
(773) 275-3200
Entity
Organization
Contact information
Practice address
5315 N SHERIDAN RD, CHICAGO, IL 60640-2531
(773) 275-3200
(773) 275-2877
Mailing address
5315 N SHERIDAN RD, CHICAGO, IL 60640-2531
(773) 275-3200
(773) 275-2877
Taxonomy
Speciality
Code
Description
License number
State
261QM1300X
Multi-Specialty Clinic/Center
Primary
—
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
01630328
BLUE CROSS ID
IL
Enumeration date
04/09/2007
Last updated
08/22/2020
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