HEARTLAND ALLIANCE HEALTH NPI 1619134111

NPI Information

NPI: 1619134111
Provider Name: HEARTLAND ALLIANCE HEALTH

Former Legal Business Name: HEARTLAND HEALTH OUTREACH

Classification: Clinic/Center - 261QR0405X
Entity Type: Organization

Specialization: Rehabilitation, Substance Use Disorder

Address:
1015 W LAWRENCE AVE
CHICAGO, IL
ZIP 60640
Phone: (773) 751-4129
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HEARTLAND ALLIANCE HEALTH is a rehabilitation and substance use disorder clinic center in Chicago, IL. HEARTLAND ALLIANCE HEALTH NPI is 1619134111. The provider is registered as an organization entity type.
The provider Former Legal Business Name Is Heartland Health Outreach.

The provider's business location address is:

1015 W LAWRENCE AVE
CHICAGO, IL
ZIP 60640-017
Phone: (773) 751-4129
Fax: (773) 751-4175

The provider's authorized official is Jimmy Valentin .
The authorized official title is Director, Revenue Cycle Management and has the following contact phone number (773) 751-4129.

The enumeration date for this NPI number is 5/21/2008 and was last updated on 11/17/2020.

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	261QR0405X	Clinic/Center	Rehabilitation, Substance Use Disorder	077560001	ILLINOIS	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	022	MEDICAID	ILLINOIS

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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