Organization
MIORA
Active
Parent organization
LIFETIME FITNESS
Organization subpart
Yes
Provider details
NPI number
Legal business name
LIFETIME FITNESS
Authorized official
ARIELLE DOVER JANICEK APRN (NURSE PRACTITIONER)
(866) 770-1588
Entity
Organization
Contact information
Practice address
1618 SHERMAN AVE, EVANSTON, IL 60201-3711
(855) 430-5433
Mailing address
1618 SHERMAN AVE, EVANSTON, IL 60201-3711
(855) 430-5433
Taxonomy
Speciality
Code
Description
License number
State
202D00000X
Integrative Medicine Physician
Primary
—
—
2083P0901X
Public Health & General Preventive Medicine Physician
—
—
Other
Enumeration date
04/14/2025
Last updated
04/14/2025
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