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:
1015 W LAWRENCE AVE
CHICAGO, IL
ZIP 60640
Phone: (773) 275-2060
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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:
1015 W LAWRENCE AVE
CHICAGO, IL
ZIP 60640-017
Phone: (773) 275-2060
Fax: (773) 275-3689
The provider's authorized official is Edward Stellon .
The authorized official title is Executive Director and has the following contact phone number (312) 405-0802.
The enumeration date for this NPI number is 2/22/2007 and was last updated on 10/15/2020.