| Heartland Alliance Health | |
|
932 W Washington Blvd Fl 2 Chicago IL 60607-2217 | |
| (773) 275-2586 | |
| Not Available |
| Full Name | Heartland Alliance Health |
|---|---|
| Speciality | Clinic/Center |
| Location | 932 W Washington Blvd Fl 2, Chicago, Illinois |
| Authorized Official Name and Position | Edward Stellon (EXECUTIVE DIRECTOR) |
| Authorized Official Contact | 3124050802 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Heartland Alliance Health 1015 W Lawrence Ave Chicago IL 60640-5017 Ph: (773) 751-4129 | Heartland Alliance Health 932 W Washington Blvd Fl 2 Chicago IL 60607-2217 Ph: (773) 275-2586 |
| NPI Number | 1306279070 |
|---|---|
| Provider Enumeration Date | 08/16/2013 |
| Last Update Date | 10/15/2020 |
| Medicare PECOS PAC ID | 5890696686 |
|---|---|
| Medicare Enrollment ID | O20131122001876 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1306279070 | NPI | - | NPPES |
| 1306279070 | Medicaid | IL | |
| 2283208 | Other | IL | BUSINESS LICENSE |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | 38369 (Illinois) | Primary |
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