Organization · Type 2 NPI

Heartland Alliance Health

Substance Use Disorder Rehabilitation Clinic/Center · Chicago, IL

NPI number 1619134111 Active

Practice location

1015 W Lawrence Ave
Chicago, IL 60640-5017

Call (773) 751-4129 Map

Fax (773) 751-4175

Mailing address

4750 N Sheridan Rd Ste 449
Chicago, IL 60640-5078

Specialties and licenses

Taxonomy	Code	License
Substance Use Disorder Rehabilitation Clinic/Center Primary	261QR0405X	077560001 (IL)

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NPI record

NPI: 1619134111
Entity type: Organization (Type 2)
Issued: May 21, 2008
Last updated: Nov 17, 2020
Status: Active

Other names

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Heartland Health Outreach · former legal business name
Heartland Health Outreach Pathway · other name

Authorized official

Jimmy Valentin
Director, Revenue Cycle Management
(773) 751-4129

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About NPI 1619134111

Heartland Alliance Health's National Provider Identifier is 1619134111, issued on May 21, 2008. The primary taxonomy on file is Substance Use Disorder Rehabilitation Clinic/Center (261QR0405X), and the practice location is in Chicago, IL. The record was last updated on Nov 17, 2020.