Organization
LIVE IGNITE THRIVE LIMITED
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ADAM WELDZIUS (MEDICAL DIRECTOR)
(847) 452-6533
Entity
Organization
Contact information
Practice address
15614 S HARLEM AVE STE C, ORLAND PARK, IL 60462-4401
(708) 866-5900
(708) 866-5903
Mailing address
2345 E OFFNER RD, BEECHER, IL 60401-3784
(847) 452-6533
Taxonomy
Speciality
Code
Description
License number
State
261QM1300X
Multi-Specialty Clinic/Center
Primary
—
—
Other
Enumeration date
10/04/2020
Last updated
09/02/2021
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