| Healthy Life, Llc | |
|
200 W Madison St Ste 2100 Chicago IL 60606-3521 | |
| (248) 495-8165 | |
| (773) 353-1581 |
| Full Name | Healthy Life, Llc |
|---|---|
| Speciality | Clinic/Center |
| Location | 200 W Madison St Ste 2100, Chicago, Illinois |
| Authorized Official Name and Position | Cassandra Kandah (FOUNDER) |
| Authorized Official Contact | 2484958165 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Healthy Life, Llc 2729 N Maplewood Ave Chicago IL 60647-1930 Ph: (248) 495-8165 | Healthy Life, Llc 200 W Madison St Ste 2100 Chicago IL 60606-3521 Ph: (248) 495-8165 |
| NPI Number | 1770046575 |
|---|---|
| Provider Enumeration Date | 04/09/2019 |
| Last Update Date | 04/23/2019 |
| Medicare PECOS PAC ID | 6608118435 |
|---|---|
| Medicare Enrollment ID | O20190605002068 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1770046575 | NPI | - | NPPES |
| Provider Name | Cassandra Christine Kandah |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1386114122 PECOS PAC ID: 2961744701 Enrollment ID: I20190605002726 |
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