Organization
LIFE CHOICE HEALTH CENTER, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. GEORGENA DIANA WILEY DNP (OWNER)
(773) 559-1397
Entity
Organization
Contact information
Practice address
1130 S CANAL ST STE 1399, CHICAGO, IL 60607-5058
(773) 559-1397
Mailing address
1130 S CANAL ST STE 1399, CHICAGO, IL 60607-5058
(773) 559-1397
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
—
—
Other
Enumeration date
06/04/2025
Last updated
07/14/2025
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