Organization
LIFESTART NATIONAL FITNESS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MIKE FLANAGAN (PRESIDENT)
(312) 627-1300
Entity
Organization
Contact information
Practice address
125 S WACKER DR, SUITE 2155, CHICAGO, IL 60606-4424
(312) 627-1300
(312) 627-1317
Mailing address
125 S WACKER DR, SUITE 2155, CHICAGO, IL 60606-4424
(312) 627-1300
(312) 627-1317
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
2478
LA
133V00000X
Registered Dietitian
DN003881
PA
163W00000X
Registered Nurse
041344664
IL
246RP1900X
Phlebotomy Technician
Primary
—
—
Other
Enumeration date
12/09/2013
Last updated
12/09/2013
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