Organization
ACTIVSTYLE LLC
Active
Parent organization
ACTIVSTYLE HOLDING COMPANY
Organization subpart
Yes
Provider details
NPI number
Legal business name
ACTIVSTYLE HOLDING COMPANY
Authorized official
DARRELL DOUGLAS RAWLINGS (CEO)
(612) 895-7815
Entity
Organization
Contact information
Practice address
2139 W 95TH ST, CHICAGO, IL 60643-1018
(773) 783-4600
(773) 783-8333
Mailing address
1055 WESTGATE DR STE 100, SAINT PAUL, MN 55114-1451
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
203000538
IL
332BP3500X
Parenteral & Enteral Nutrition Supplies (DME)
203.001527
IL
Other
Enumeration date
11/03/2005
Last updated
10/31/2025
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