Organization
HEARTLAND HEALTH OUTREACH
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. GWENDOLYN R RIDDELL CNM (CERTIFIEDD NURSE MIDWIFE)
(773) 575-2586
Entity
Organization
Contact information
Practice address
1015 W LAWRENCE AVE, CHICAGO, IL 60640-5017
(773) 275-2586
(773) 275-3689
Mailing address
1348 N ARTESIAN AVE, CHICAGO, IL 60622-4998
(773) 227-6282
Taxonomy
Speciality
Code
Description
License number
State
261QC1500X
Community Health Clinic/Center
Primary
—
IL
Other
Enumeration date
04/11/2007
Last updated
08/22/2020
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