Lifelong Access

Developmental - Behavioral Pediatrics Physician · Normal, IL

Organization Active NPI

NPI number 1124731484

Practice location

1302 Franklin Ave Ste L500
Normal, IL 61761-3551
Phone
(309) 452-0069

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NPI record

NPI
1124731484
Entity type
Organization (Type 2)
Enumeration date
January 3, 2023
Last updated
August 27, 2024
Certified
August 27, 2024
Organization subpart
No

Specialties & taxonomy codes

TaxonomyCodeLicenseState
Developmental - Behavioral Pediatrics Physician Primary 2080P0006X — —

Mailing address

2000 Jacobssen Dr
Normal, IL 61761-6277
Phone
(309) 451-8888
Fax
(309) 451-8989

Authorized official

Name
Patrick Dyce Bailey
Title
Program Supports Specialist
Phone
(309) 451-8888

Other names

  • Marcfirst

About Lifelong Access

Lifelong Access is a healthcare organization registered in the NPI registry with the primary taxonomy Developmental - Behavioral Pediatrics Physician (code 2080P0006X). The practice location is 1302 Franklin Ave Ste L500, Normal, IL 61761-3551. The NPI number 1124731484 was assigned on January 3, 2023 and the record was last updated on August 27, 2024.

The authorized official for this organization is Patrick Dyce Bailey, Program Supports Specialist.

Frequently asked questions

What is the NPI number of Lifelong Access?

The NPI number is 1124731484.

What is the phone number of Lifelong Access?

The phone number listed for the practice location is (309) 452-0069.

Where is Lifelong Access located?

1302 Franklin Ave Ste L500, Normal, IL 61761-3551.

What is the taxonomy code for Lifelong Access?

The primary taxonomy code is 2080P0006X – Developmental - Behavioral Pediatrics Physician.

Is this information correct?

All details come from the public NPPES registry. Providers can update their record at nppes.cms.hhs.gov; changes appear here after the next weekly update.