Provider Demographics
NPI:1962977330
Name:NEXT MAN UP LLC
Entity type:Organization
Organization Name:NEXT MAN UP LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING MEMBER
Authorized Official - Prefix:MS
Authorized Official - First Name:MARVA
Authorized Official - Middle Name:LYNN
Authorized Official - Last Name:RODGERS COOKSEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:312-402-8482
Mailing Address - Street 1:946 E 43RD ST STE 1
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60653-3025
Mailing Address - Country:US
Mailing Address - Phone:773-966-5268
Mailing Address - Fax:
Practice Address - Street 1:946 E 43RD ST STE 1
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60653-3025
Practice Address - Country:US
Practice Address - Phone:773-966-5268
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-10-11
Last Update Date:2018-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage TherapistGroup - Single Specialty