Lifestyle Rejuvenation Medical Group PLLC · Multi-Specialty Clinic/Center

1740 E 55th Street, Chicago, IL 60615

Overview

Lifestyle Rejuvenation Medical Group PLLC is a Multi-Specialty Clinic/Center (organization) practicing in Chicago, Illinois. The National Provider Identifier (NPI) is #1134781974, which was assigned on July 2, 2019, and the registration record was last updated on May 29, 2020. The practitioner's main practice location is at 1740 E 55th Street, Chicago, IL 60615; the contact telephone number is 7736679053. The primary taxonomy of Lifestyle Rejuvenation Medical Group PLLC is Multi-Specialty Clinic/Center (261QM1300X), with specialization in Multi-Specialty. The authorized official for Lifestyle Rejuvenation Medical Group PLLC is Dr. Robert Van Higginbottom (Ceo).

Provider Information

NPI 1134781974
Entity Type Organization
Organization Name LIFESTYLE REJUVENATION MEDICAL GROUP PLLC
Provider Name LIFESTYLE REJUVENATION MEDICAL GROUP PLLC
Practice Address 1740 E 55th Street
Chicago
IL 60615
Practice Telephone 7736679053
Mailing Address 1740 E 55th St
Chicago
IL 60615-5966
Mailing Telephone 7736679053
Certification Date 2020-05-29
Enumeration Date 2019-07-02
Last Update Date 2020-05-29
Is Organization Subpart N

Authorized Official Information

Official Name DR. ROBERT VAN HIGGINBOTTOM
Official Title CEO
Credential DC
Telephone 7736679053

Taxonomy and Licenses

PrimaryCodeClassificationSpecializationTaxonomy GroupLicense NumberLicense State
N111N00000XChiropractor193200000X MULTI-SPECIALTY GROUP
N111NR0400XChiropractorRehabilitation193200000X MULTI-SPECIALTY GROUP
N261QH0100XClinic/CenterHealth Service
Y261QM1300XClinic/CenterMulti-Specialty
N261QM2500XClinic/CenterMedical Specialty
N261QP2000XClinic/CenterPhysical Therapy
N261QP2300XClinic/CenterPrimary Care
N261QP3300XClinic/CenterPain
N261QR0200XClinic/CenterRadiology
N261QR0400XClinic/CenterRehabilitation
N261QR0800XClinic/CenterRecovery Care
N302R00000XHealth Maintenance Organization
N305R00000XPreferred Provider Organization
N305S00000XPoint of Service
N332B00000XDurable Medical Equipment & Medical Supplies

Secondary Practice Locations

AddressTelephoneFax
1746 E 55th St, Chicago, IL 6061559667736679053
1746 E 55th St, Chicago, IL 6061559667736679053 ext.

Taxonomy Information

Primary Taxonomy

Code 261QM1300X
Taxonomy Multi-Specialty Clinic/Center
Classification Clinic/Center
Specialization Multi-Specialty
Grouping Ambulatory Health Care Facilities
Definition: Definition to come...

Other Taxonomy

Code 111N00000X
Taxonomy Chiropractor
Classification Chiropractor
Grouping Chiropractic Providers
Definition: A provider qualified by a Doctor of Chiropractic (D.C.), licensed by the State and who practices chiropractic medicine -that discipline within the healing arts which deals with the nervous system and its relationship to the spinal column and its interrelationship with other body systems.

Other Taxonomy

Code 111NR0400X
Taxonomy Rehabilitation Chiropractor
Classification Chiropractor
Specialization Rehabilitation
Grouping Chiropractic Providers
Definition: Rehabilitation is the discipline focused on restoring a patient's functional abilities to pre-injury or pre-disease status. Functional abilities are defined as those activities in one's daily life, work, or sports and recreational activities that an individual participates in. Relevant impairments (e.g. strength, endurance, flexibility, motor control, etc.) are often intermediate goals of rehabilitation, but the final goal of successful care is return to participation in activities in which the patient was successful before the onset of the injury or disease. Essential to a rehabilitation approach is a focus on patient-centered outcomes such as independence and self-management or self-care skills.
Notes: Source: The American Chiropractic Association (ACA) and the ACA Council on Physiological Therapeutics [7/1/2006: new]

Other Taxonomy

Code 261QH0100X
Taxonomy Health Service Clinic/Center
Classification Clinic/Center
Specialization Health Service
Grouping Ambulatory Health Care Facilities
Definition: Definition to come...
Notes: [7/1/2006: modified title]

Other Taxonomy

Code 261QM2500X
Taxonomy Medical Specialty Clinic/Center
Classification Clinic/Center
Specialization Medical Specialty
Grouping Ambulatory Health Care Facilities
Definition: An entity, facility, or distinct part of a facility providing diagnostic, treatment, and prescriptive services related to a specific area of medical specialization. Frequently used for Title V related Children's Specialty services or to meet specific public health needs (e.g., infectious diseases or breast and cervical cancer).
Notes: [7/1/2003: new]

Other Taxonomy

Code 261QP2000X
Taxonomy Physical Therapy Clinic/Center
Classification Clinic/Center
Specialization Physical Therapy
Grouping Ambulatory Health Care Facilities
Definition: An entity, facility, or distinct part of a facility providing diagnostic and treatment services related to physical rehabilitation. Physical therapy is a dynamic profession with an established theoretical and scientific base and widespread clinical applications in the restoration, maintenance, and promotion of optimal physical function. Physical therapists and physical therapist assistants are licensed health care professionals who are experts in the movement system and help individuals maintain, restore, and improve movement, activity, and functioning, thereby enabling optimal performance and enhancing health, well-being, and quality of life. Their services prevent, minimize, or eliminate impairments of body functions and structures, activity limitations, and participation restrictions. Physical therapy is provided for individuals of all ages who have or may develop impairments, activity limitations, and participation restrictions related to (1) conditions of the musculoskeletal, neuromuscular, cardiovascular, pulmonary, and/or integumentary systems or (2) the negative effects attributable to unique personal and environmental factors as they relate to human performance.
Notes: Source: Guide to PT Practice 3.0 [1/1/2020: definition added] Additional resources: http://guidetoptpractice.apta.org/ ; American Physical Therapy Association, www.apta.org.

Other Taxonomy

Code 261QP2300X
Taxonomy Primary Care Clinic/Center
Classification Clinic/Center
Specialization Primary Care
Grouping Ambulatory Health Care Facilities
Definition: Definition to come...

Other Taxonomy

Code 261QP3300X
Taxonomy Pain Clinic/Center
Classification Clinic/Center
Specialization Pain
Grouping Ambulatory Health Care Facilities
Definition: Definition to come...

Other Taxonomy

Code 261QR0200X
Taxonomy Radiology Clinic/Center
Classification Clinic/Center
Specialization Radiology
Grouping Ambulatory Health Care Facilities
Definition: Definition to come...

Other Taxonomy

Code 261QR0400X
Taxonomy Rehabilitation Clinic/Center
Classification Clinic/Center
Specialization Rehabilitation
Grouping Ambulatory Health Care Facilities
Definition: Definition to come...

Other Taxonomy

Code 261QR0800X
Taxonomy Recovery Care Clinic/Center
Classification Clinic/Center
Specialization Recovery Care
Grouping Ambulatory Health Care Facilities
Definition: Definition to come...

Other Taxonomy

Code 302R00000X
Taxonomy Health Maintenance Organization
Classification Health Maintenance Organization
Grouping Managed Care Organizations
Definition: (1) A form of health insurance in which its members prepay a premium for the HMO's health services which generally include inpatient and ambulatory care. For the patient, an HMO means reduced out-of-pocket costs (i.e. no deductible), no paperwork (i.e. insurance forms), and only a small copayment for each office visit to cover the paperwork handled by the HMO; (2) A organization of health care personnel and facilities that provides a comprehensive range of health services to an enrolled population for a fixed sum of money paid in advance for a specified period of time. These health services include a wide variety of medical treatments and consults, inpatient and outpatient hospitalization, home health service, ambulance service, and sometimes dental and pharmacy services. The HMO may be organized as a group model, an individual practice association (IPA), a network model or a staff model.
Notes: Source: (1) Medical Interface: Managed Care A thru Z- Managed Care Terms published by Medicom International, Bronxville, New York Telephone (914) 337-5023, p. 20; (2) "Glossary of terms used in managed care" Developed by the Managed Care Assembly (MCA) of Medical Group Management Association (MGMA), MGM Journal, September/October 1995, p. 58

Other Taxonomy

Code 305R00000X
Taxonomy Preferred Provider Organization
Classification Preferred Provider Organization
Grouping Managed Care Organizations
Definition: A group of physicians and/or hospitals who contract with an employer to provide services to their employees. In a PPO, the patient may got to the physician of his/her choice, even if that physician does not participate in the PPO, but the patient receives care at a lower benefit level.
Notes: Source: "Glossary of terms used in managed care" Developed by the Managed Care Assembly (MCA) of Medical Group Management Association (MGMA), MGM Journal, September/ October 1995, p. 62

Other Taxonomy

Code 305S00000X
Taxonomy Point of Service
Classification Point of Service
Grouping Managed Care Organizations
Definition: This product may also be called an open-ended HMO and offers a transition product incorporating features of both HMOs and PPOs. Beneficiaries are enrolled in an HMO but have the option to go outside the networks for an additional cost.
Notes: Source: "Glossary of terms used in managed care" Developed by the Managed Care Assembly (MCA) of Medical Group Management Association (MGMA), MGM Journal, September/October 1995, p. 62

Other Taxonomy

Code 332B00000X
Taxonomy Durable Medical Equipment & Medical Supplies
Classification Durable Medical Equipment & Medical Supplies
Grouping Suppliers
Definition: A supplier of medical equipment such as respirators, wheelchairs, home dialysis systems, or monitoring systems, that are prescribed by a physician for a patient's use in the home and that are usable for an extended period of time.

Providers with the same taxonomy

Provider NameAddressTaxonomyEnumeration Date
Premise Health of California Medical, P.c 20263 S Western Ave, Torrance, CA 90501-1310Multi-Specialty Clinic/Center2024-02-27
Premise Health of Missouri Medical, P.C. 201 Ne Mulberry St, Lees Summit, MO 64086-5881Multi-Specialty Clinic/Center2024-03-06
J9 Medical Management LLC 11861 S Sam Houston Pkwy W Ste A, Houston, TX 77031-2362Multi-Specialty Clinic/Center2024-03-04
Medcall Medical 1255 W Baseline Rd Ste B-260, Mesa, AZ 85202-5820Multi-Specialty Clinic/Center2024-02-26
True North Counseling, LLC 8910 Greeneway Commons Pl, Louisville, KY 40220-4065Multi-Specialty Clinic/Center2024-03-08
Embracing Authenticity Inc 95 Golf Course Rd Ste 105, Logan, UT 84321-5990Multi-Specialty Clinic/Center2024-03-07
Hillstone Medical Group Inc 8631 W 3rd St Ste 1115e, Los Angeles, CA 90048-5901Multi-Specialty Clinic/Center2024-02-23
Centennial Housing & Community Services Corporation 104 Medical Dr, Williamston, NC 27892-2156Multi-Specialty Clinic/Center2024-03-07
Clear Choices, LLC 373 Cleveland St, Rochester, PA 15074-1623Multi-Specialty Clinic/Center2024-02-23
Mhn Infusions Group LLC 1369 E Hyde Park Blvd Unit G1, Chicago, IL 60615-2918Multi-Specialty Clinic/Center2024-02-29
Find all providers with the same taxonomy

Location Information

Street Address 1740 E 55TH STREET
City CHICAGO
State IL
Zip Code 60615
Country US

Providers in the same zip code

Provider NameAddressTaxonomyEnumeration Date
Heather Collins 4943 S Saint Lawrence Ave, Unit 2, Chicago, IL 60615Mental Health Counselor2023-01-20
Connie Frances Davis 5481 S. Cornell, Chicago, IL 60615Massage Therapist2020-08-17
Jonah Waseberg 1100 E.55th St, Chicago, IL 60615Professional Counselor2017-09-21
Highland Park Cvs, L.L.C. · Cvs Pharmacy #17686 1346 E 53rd St., Chicago, IL 60615Durable Medical Equipment & Medical Supplies2016-10-13
Redefine You Therapy and Consultation 5113 S Harper Ave Suite 2c, Chicago, IL 60615Counselor2022-10-17
Nivea Lathan 1510 E. 55th, Chicago, IL 60615Occupational Therapist2020-04-03
Cook County · Provident Dialysis Center 430 East 51st Pl, Chicago, IL 60615Renal Dialysis Technician2022-03-08
Theodore Tran 430 E. 50th Place, Chicago, IL 60615Pharmacist2016-09-22
Courtney Leniece Reed 1228 E 53rd Street, Chicago, Chicago, IL 60615Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist2022-10-31
Melissa Guzicki 1520 North Kostn, Near North Health Center -North Kostner, Chicago, IL 60615Mental Health Counselor2016-08-31
Find all providers in the same zip code

Similar Providers

Providers with similar names

Provider NameAddressTaxonomyEnumeration Date
First Light Lifestyle Medical Clinic PLLC 30 7th St W Ste Ll-50, Dickinson, ND 58601-4335Family Medicine Physician2022-10-12
Lifestyle Medical Group PLLC 14885 Southwest Fwy, Sugar Land, TX 77478-5016Obstetrics & Gynecology Physician2016-10-12
Lifestyle Hospice Foundation, Inc. · Lifestyle Home Medical Supply 2390 Sw 4th Ave, Ontario, OR 97914-1852Durable Medical Equipment & Medical Supplies2012-05-02
Woman Rejuvenation PLLC 5373 W Alabama St Ste 204, Houston, TX 77056-5923Specialist2010-01-12
Reflexion Medical Rejuvenation Center PLLC 14815 W Bell Rd Ste 104, Surprise, AZ 85374-7603General Practice Physician2019-08-21
Joint Rejuvenation Center, PLLC 2724 Yale St, Houston, TX 77008-2120Plastic and Reconstructive Surgery Physician2018-01-08
Medical Ayurveda Rejuvenation Center A Medical Corporation 355 Placentia Ave, Suite 201, Newport Beach, CA 92663-3311Health Service Clinic/Center2007-03-06
Lifestyle Healthcare, PLLC · Lifestyle Chiropractic and Massage, PLLC 134 Keene Rd, Richland, WA 99352-8683Chiropractor2013-11-18
Lifestyle Medical Center, PLLC 4505 S Harvard Ave, Tulsa, OK 74135-2905General Practice Physician2017-09-27
Lifestyle Medical Group, PLLC · The Center for Natural Medicine 4535 Harding Pike Ste 210, Nashville, TN 37205-2120Internist Chiropractor2008-01-11

Improve Information

Do you have more infomration about Lifestyle Rejuvenation Medical Group PLLC? Please fill in the following form.


Dataset Information

This dataset includes over five million health care providers who are assigned National Provider Identifier (NPI) in the National Plan and Provider Enumeration System (NPPES), developed by the Centers for Medicare & Medicaid Services (CMS). Covered health care providers and all health plans and health care clearinghouses must use the NPIs in the administrative and financial transactions adopted under Health Insurance Portability and Accountability Act (HIPAA). Each provider is registered with the NPI, full name, status, address, taxonomy, other identifiers, etc.

Subject Transparency and Disclosure
Jurisdiction Federal
Data Provider National Plan and Provider Enumeration System (NPPES), by the Centers for Medicare & Medicaid Services (CMS)
Source download.cms.gov

Dataset Details

The National Provider Identifier (NPI) is a Health Insurance Portability and Accountability Act (HIPAA) Administrative Simplification Standard. The NPI is a unique identification number for covered health care providers and all health plans and health care clearinghouses, who must use the NPIs in the administrative and financial transactions adopted under HIPAA. The NPI is a 10-position, intelligence-free numeric identifier (10-digit number).

All health care providers who are HIPAA-covered entities, whether individuals or organizations, must get an NPI. A HIPAA-covered entity is a health care provider that conducts certain transactions in electronic form, or a health care clearinghouse, or a health plan (including commercial plans, Medicare, and Medicaid).

Centers for Medicare & Medicaid Services (CMS) has developed the National Plan and Provider Enumeration System (NPPES) to assign unique identifiers to health care providers. The National Provider Indentifier (NPI) has been the standard identifier for all HIPAA-covered entities (health care providers) since May 23, 2007. Small health plans were required to obtain and use an NPI by May 23, 2008.

This dataset includes over five million health care providers (individuals and organizations) who are assigned NPI. The provider data elements are disclosed to the public by the Centers for Medicare & Medicaid Services (CMS) under the Freedom of Information Act (FOIA), as listed in the NPPES Data Dissemination Notice (CMS-6060-N). The NPI final rules define the following elements which required to be disclosed as determined by Department of Health & Human Services (HHS): NPI, Entity Type, Provider Name, Credential, Business Mailing Address, Business Location Address, Healthcare Provider Taxonomy Code, Other Provider Identifier, Provider Enumeration Date, NPI Deactivation Date, Provider License Number, Authorized Official Name and Contact Information.