AGELESS MEN'S HEALTH – NPI #1114448644
Family Medicine

The NUCC recommends this code not be used. Choose a more appropriate code.

AGELESS MEN'S HEALTH is a provider located in CHICAGO, IL. NPPES has assigned the NPI number 1114448644 to AGELESS MEN'S HEALTH on July 06, 2017. It is a Type-2 NPI, indicating this NPI number is associated with an organization. Since the name “AGELESS MEN'S HEALTH” is a dba name, the actual legal business name for this organization is AGELESS MEN'S HEALTH HOLDINGS INC. The primary taxonomy selected by this provider is 207QA0505X from the Health Care Provider Taxonomy code set, which is classified as Family Medicine, specializing in Adult Medicine

The NPI profile was last updated on Nov 11, 2024. Use the NPI data found here to bill health insurance companies, identify providers enrolled in Medicare and Medicaid services or other HIPAA compliant transactions. See the complete NPI profile for AGELESS MEN'S HEALTH below.

NPI Profile for
AGELESS MEN'S HEALTH HOLDINGS INC

NPI Number
1114448644
Enumeration Date

(about 9 years ago)
Entity Type
Type-2  Organization
Organization health care providers may have a single employee or thousands of employees. An example is an incorporated individual who is an organization's only employee.
Legal Name
AGELESS MEN'S HEALTH HOLDINGS INC
Doing Business As (dba): AGELESS MEN'S HEALTH
Primary location
1729 N CLYBOURN AVE
CHICAGO, IL 60614-6503
Phone: (312) 291-8335 Fax: (312) 291-8337
1 Other location(s):
1535 Lake Cook Rd Ste 212
Northbrook, IL 60062-1451
Phone: (312) 374-3947
Mailing address
Same as primary location
Organization Subpart
No
Authorized Official
AMANDA WILKINSON
BUSINESS OPERATIONS DIRECTOR
Phone: (702) 818-0446
Updated
Certification Date
Nov 11, 2024

Note: NPPES allows providers to attest to the accuracy of their NPI data. When a provider request any change to the NPI record, they will be able to attest to their changed NPI data, resulting in an updated certification date.

Taxonomy Code(s)

A taxonomy code is a code that describes the health care service provider's type, classification, and the area of specialization. The primary specialty for this provider is indicated as (Primary) below.

Taxonomy Classification / Specialization State License
207QA0505X
- Family Medicine / Adult Medicine (Primary)

The taxonomy codes are selected by the provider at the time of NPI registration. Selection of a taxonomy code does not replace any credentialing or validation process that the provider requesting the code should complete.