360 ACTIVE RECOVERY NPI 1619428273

NPI Information

NPI: 1619428273
Provider Name: 360 ACTIVE RECOVERY
Classification: Clinic/Center - 261QH0100X
Entity Type: Organization

Specialization: Health Service

Address:
2221 W NORTH AVE
#1
CHICAGO, IL
ZIP 60647
Phone: (872) 203-3500
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360 ACTIVE RECOVERY is a health service clinic center in Chicago, IL. 360 ACTIVE RECOVERY NPI is 1619428273. The provider is registered as an organization entity type.

The provider's business location address is:

2221 W NORTH AVE
#1
CHICAGO, IL
ZIP 60647-429
Phone: (872) 203-3500

The provider's authorized official is Julius Hearn .
The authorized official title is Ceo and has the following contact phone number (872) 203-3500.

The enumeration date for this NPI number is 10/19/2016 and was last updated on 10/19/2016.

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	2487457	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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