NPI: 1538294483
Provider Name: HEARTLAND ALLIANCE HEALTH
Former Legal Business Name: HEARTLAND HEALTH OUTREACH, INC.
Classification: Clinic/Center - 261QF0400X
Entity Type: Organization
Specialization: Federally Qualified Health Center (FQHC)
Address:
4009 N BROADWAY ST
CHICAGO, IL
ZIP 60613
Phone: (773) 275-2586
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HEARTLAND ALLIANCE HEALTH is a federally qualified health center (fqhc) clinic center in Chicago, IL. HEARTLAND ALLIANCE HEALTH NPI is 1538294483. The provider is registered as an organization entity type.
The provider Former Legal Business Name Is Heartland Health Outreach, Inc..
The provider's business location address is:
4009 N BROADWAY ST
CHICAGO, IL
ZIP 60613-110
Phone: (773) 275-2586
Fax: (773) 751-4175
The provider's authorized official is Jimmy Valentin .
The authorized official title is Sr. Director, Health Information Sy and has the following contact phone number (773) 220-8562.
The enumeration date for this NPI number is 2/22/2007 and was last updated on 4/1/2024.