| Lifeline Behavioral Healthcare Ltd. | |
|
18301 Distinctive Dr Orland Park IL 60467-9461 | |
| (708) 928-5700 | |
| (708) 570-1617 |
| Full Name | Lifeline Behavioral Healthcare Ltd. |
|---|---|
| Speciality | Counselor |
| Location | 18301 Distinctive Dr, Orland Park, Illinois |
| Authorized Official Name and Position | Sheryl L Ankrom (PRESIDENT) |
| Authorized Official Contact | 7086061334 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Lifeline Behavioral Healthcare Ltd. 18301 Distinctive Dr Orland Park IL 60467-9461 Ph: (708) 928-5700 | Lifeline Behavioral Healthcare Ltd. 18301 Distinctive Dr Orland Park IL 60467-9461 Ph: (708) 928-5700 |
| NPI Number | 1114319043 |
|---|---|
| Provider Enumeration Date | 03/02/2015 |
| Last Update Date | 01/10/2024 |
| Certification Date | 01/10/2024 |
| Medicare PECOS PAC ID | 2062774169 |
|---|---|
| Medicare Enrollment ID | O20180330000951 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1114319043 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YP2500X | Counselor - Professional | 180007337 (Illinois) | Primary |
| Provider Name | Amy Pawlowski |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1457528747 PECOS PAC ID: 7214109446 Enrollment ID: I20161108000880 |
| Provider Name | Lynn M King Panepinto |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1235865718 PECOS PAC ID: 3375911779 Enrollment ID: I20221116000044 |
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