Livingstone Partners Research
Advisory Approach
Livingstone Partners is an independent, global mid-market investment bank specializing in M&A and debt advisory services. Founded in 2007, the firm has established itself as a specialist advisor to lower middle market companies with enterprise values typically between $3 million and $73 million. The firm operates with a clear thesis: independence ensures their incentives align with client interests, while unrelenting advocacy drives exceptional outcomes. Livingstone's approach emphasizes creativity in structuring transaction processes tailored to specific client needs, supported by partner dedication that prioritizes deal execution above all else.
The firm's core values—independence, unrelenting advocacy, creativity, partner dedication, and integrity—guide every engagement. As an independent partnership rather than a subsidiary of a larger financial institution, Livingstone maintains decision-making autonomy and avoids conflicts of interest that can plague larger banks. This independence, combined with a collaborative global partnership model, allows Livingstone to provide highly personalized service while accessing international buyer networks.
Sector Focus
Livingstone organizes its practice around four primary sectors: Business & Technology Services, Consumer, Healthcare, and Industrial. This sector-specialized approach ensures that bankers develop deep domain expertise and contemporaneous market knowledge.
The Healthcare practice represents Livingstone's deepest expertise, particularly in physical therapy, dental services, autism and behavioral health, home health, and physician practice management. The firm has completed over two dozen physical therapy transactions alone, establishing itself as the most active middle-market advisor to this sector. Notable transactions include multiple sales to Confluent Health and U.S. Physical Therapy, two of the nation's largest physical therapy platforms. In dental services, Livingstone has advised on transactions involving DSOs affiliating with Heartland Dental (KKR portfolio) and sales to ProSmile.
The Business & Technology Services practice covers BPO, IT services, software and digital platforms, marketing services, financial services, and supply chain & logistics. Deal experience includes recruitment marketing, IT consulting, digital commerce, and technology-enabled services.
The Industrials practice focuses on building products, industrial technology, aerospace & defense, distribution, and metals & advanced materials. Transactions range from steel drum manufacturers to valve and instrumentation specialists, reflecting the team's comfort with technical, asset-intensive businesses.
The Consumer practice spans food & beverage, CPG, retail, travel & leisure, and consumer services. Deal experience includes craft breweries, home care franchisors, and consumer products companies.
Deal Track Record
Livingstone maintains an active transaction pace, closing 80+ deals annually across its global offices. Recent transactions illustrate the firm's sector depth and geographic reach:
Healthcare Transactions (2023-2025): Fitness Quest Physical Therapy to Confluent Health (2024), Destiny Dental to ProSmile (2024), Spine & Sport Physical Therapy to PRN (2025), Metro Physical & Aquatic Therapy partnership with U.S. Physical Therapy (2024), Clarity Testing Services partnership with U.S. Physical Therapy (2025), Cosmetic Skin & Laser Center recapitalization with Incline Equity Partners (2023), Centers for Autism & Related Disorders asset sales (bankruptcy), and NexPhase acquisition of Behavior Frontiers.
Business & Technology Services: RecruitMilitary sale to company management from Thompson Street Capital Partners (2025), Allitix acquisition by Accenture (2024), Viewport.ai sale to Assai Software Services (Vortex Capital Partners portfolio), and Extens acquisition of Medicore with financing arranged.
Industrial Transactions: Skolnik Industries sale to Pelican Energy Partners (2025) – a leading manufacturer of steel drums for the nuclear industry, Lesman Instrument Company sale to Kele (The Stephens Group portfolio), Keidel Supply sale to Winsupply, B.R. Johnson sale to Cook & Boardman, Ives Equipment Corporation sale to Motion & Control Enterprises, and multiple building products distributors.
The firm's physical therapy practice is particularly noteworthy, having advised on eight platform sales with combined value approaching $1 billion since late 2021. Major consolidators like Confluent Health, U.S. Physical Therapy, and Partners Group repeatedly turn to Livingstone for sell-side representation, reflecting the firm's reputation and relationships in this specialist market.
Process & Fee Structure
Livingstone runs institutional-quality sell-side processes tailored to lower middle market companies. The firm emphasizes exhaustive buyer outreach—typically 200-400 targeted buyers per engagement—to ensure competitive tension and optimal outcomes. Process management includes comprehensive quality of earnings support, management presentation coaching, and structured data room preparation.
While specific fee structures are not publicly disclosed, Livingstone likely employs a modified Lehman or similar success-based model typical of lower middle market advisors. Given their transaction size range ($3M-$73M), retainers likely range from $10K-$25K monthly, credited against success fees. The firm requires exclusivity and focuses on engagements where they can deliver meaningful value through their sector expertise and buyer relationships.
Buyer Network
Livingstone maintains relationships with 2,000+ active private equity firms and strategic acquirers globally. The firm's strength in healthcare services is evidenced by repeat transactions with major consolidators including Confluent Health, U.S. Physical Therapy, Incline Equity Partners, Partners Group, and KKR (via Heartland Dental). In industrials, the firm has closed deals with Pelican Energy Partners, The Stephens Group, Winsupply, and Motion & Control Enterprises.
Cross-border capability is a differentiator, with offices in Amsterdam, Düsseldorf, Frankfurt, London, Madrid, Milan, Seoul, Stockholm, and Valencia enabling access to European and Asian buyers. This international reach allows Livingstone to identify strategic acquirers that domestic-focused advisors may miss.
Competitive Positioning
Livingstone differentiates through:
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Sector Specialization: Deep vertical expertise in healthcare (particularly physical therapy and dental), industrials, and business services. Bankers develop contemporaneous knowledge of active buyers, valuation metrics, and sector trends.
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Independence: As an independent partnership, Livingstone avoids the conflicts of interest and bureaucracy that can plague bulge bracket and regional banks. Decision-making autonomy allows creative deal structures and client-first processes.
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Global Reach with Local Presence: 13 offices across three time zones provide 24/7 deal capability and access to international buyers while maintaining local market knowledge.
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Transactional Volume: With 80+ deals closed annually and 170+ professionals worldwide, Livingstone brings process discipline and market intelligence that smaller boutiques cannot match.
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Lower Middle Market Focus: Unlike bulge bracket banks that chase larger deals, or regional firms that lack resources, Livingstone has built its entire operation around serving $3M-$73M companies—a segment underserved by high-quality advisory.
Not a Fit If
Livingstone typically declines:
- Businesses below $3M TEV (minimum transaction size threshold)
- Pure asset sales or liquidations (focus on going-concern enterprises)
- Founders wanting limited buyer outreach (Livingstone's value is in exhaustive processes)
- Situations requiring restructuring or turnaround expertise (focus on healthy businesses)
Team
Livingstone's team comprises 170+ professionals across 13 global offices. Key leadership includes:
Chicago (Headquarters):
- Mark Carl, Managing Director – Healthcare practice leader with 45+ deals completed. Specializes in consumer-facing healthcare, home health, autism therapy, physical therapy, and physician practice management. BS, DePaul University.
- Patrick Hopkins, Managing Director – Industrials group with 20+ industrial transactions. CPA, previously Senior Manager at Ernst & Young and Robert W. Baird & Co. MBA, University of Michigan; MS Accounting, Indiana University; BA, University of Michigan.
- Ryan Buckley, Partner – Physical therapy specialist, completed over 20 PT deals. One of the most active M&A advisors in the sector.
- Brennan Libbey, Partner – Business & Technology Services, Los Angeles
- Josh Kroll, Director – Business & Technology Services, Los Angeles
International Leadership:
- Andrew Isgrig, Managing Director – Previously led Midwest Region of Deloitte Corporate Finance
- Robert Tymowski, Managing Director – Essential Services sector
- Adam Green, Director – Special Situations practice
Executive Leadership:
- Chris Allan, Chief Executive Officer
- Giovanni Savastano, Chief Operating Officer
- Lisa Maines, Executive leadership team
The firm's partner experience averages 3+ years at Livingstone, with most partners bringing 15-25 years of prior transaction experience from institutions like Deloitte, Ernst & Young, Robert W. Baird, and bulge bracket banks.
Geographic Coverage
Livingstone maintains 13 offices across the United States, Europe, and Asia:
United States: Chicago (headquarters), Los Angeles
Europe: Amsterdam, Düsseldorf, Frankfurt, London, Madrid, Milan, Stockholm, Valencia, Verona
Asia: Beijing, Seoul
This global footprint enables cross-border transaction capability and access to international strategic buyers. The firm's U.S. offices focus on domestic lower middle market companies, while European offices handle both regional transactions and cross-border deals between U.S. and European buyers. Asian offices provide buy-side advisory for Asian strategics seeking U.S. and European acquisitions.
Founded Year & Growth
Livingstone was founded in 2007, with the U.S. office established in May 2007. The firm has grown from two founding partners to 170+ professionals globally. Since late 2021, the Healthcare practice alone has completed eight physical therapy platform sales with combined value approaching $1 billion, demonstrating rapid growth and sector dominance. In 2023, Livingstone completed 23 transactions globally (11 U.S.-based M&A deals totaling over $900 million), and the firm now closes 80+ transactions annually.
Total Transaction Activity
Based on public disclosures, Livingstone Partners has completed:
- 80+ transactions closed annually (current run rate)
- 1,000+ transactions completed since founding (2007-2025, estimated based on current run rate)
- $25B+ in aggregate transaction value (estimated)
The Healthcare team alone has completed 14 M&A sell-side transactions in a recent 12-month period, including 8 physical therapy platform sales approaching $1 billion in combined value. This activity level positions Livingstone as one of the most active mid-market M&A advisors in the healthcare services sector.