Organization
O2 FITNESS AND NUTRITION
Active
Organization
O2 FITNESS AND NUTRITION
Active
Other names
My Life Fitness
Organization subpart
No
Provider details
NPI number
Authorized official
PAOLA AMBROSE BA, RDN, LDN (OWNER, RDN, LDN)
(708) 819-2289
Entity
Organization
Contact information
Practice address
12609 S KROLL DR, ALSIP, IL 60803-3221
(708) 969-6110
Mailing address
4839 W 121ST PL, ALSIP, IL 60803-2943
(708) 819-2289
Taxonomy
Speciality
Code
Description
License number
State
174200000X
Meals Provider
—
—
261QH0100X
Health Service Clinic/Center
Primary
—
—
261QP3300X
Pain Clinic/Center
—
—
261QR0400X
Rehabilitation Clinic/Center
—
—
302R00000X
Health Maintenance Organization
—
—
Other
Enumeration date
03/31/2025
Last updated
03/31/2025
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