HERITAGE HEALTHCARE GROUP LLC NPI 1386995058

NPI Information

NPI: 1386995058
Provider Name: HERITAGE HEALTHCARE GROUP LLC
Classification: Clinic/Center - 261QH0100X
Entity Type: Organization

Specialization: Health Service

Address:
4356 N KENMORE AVE
APT 101
CHICAGO, IL
ZIP 60613
Phone: (312) 550-3612
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HERITAGE HEALTHCARE GROUP LLC is a health service clinic center in Chicago, IL. HERITAGE HEALTHCARE GROUP LLC NPI is 1386995058. The provider is registered as an organization entity type.

The provider's business location address is:

4356 N KENMORE AVE
APT 101
CHICAGO, IL
ZIP 60613-330
Phone: (312) 550-3612

The provider's authorized official is Andrew Dacy .
The authorized official title is Executive Director and has the following contact phone number (847) 208-7620.

The enumeration date for this NPI number is 9/21/2012 and was last updated on 9/21/2012.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	261QH0100X	Clinic/Center	Health Service	=========6	ILLINOIS	Yes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

NPI Synchronization or Removal

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