Organization
ENVISION UNLIMITED
Active
Parent organization
ENVISION UNLIMITED
Other names
Envision Wellness Program
Organization subpart
Yes
Provider details
NPI number
Legal business name
ENVISION UNLIMITED
Authorized official
NATALIE A BLIDER (DIRECTOR OF REVENUE CYCLE MANAGEMEN)
(773) 506-3014
Entity
Organization
Contact information
Practice address
4411 N RAVENSWOOD AVE FL 1, CHICAGO, IL 60640-5802
(773) 506-4313
(773) 769-1476
Mailing address
4411 N RAVENSWOOD AVE FL 1, CHICAGO, IL 60640-5802
(773) 506-4313
(773) 769-1476
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
—
—
251S00000X
Community/Behavioral Health Agency
—
—
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
18004
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
18004
—
IL
Enumeration date
05/30/2018
Last updated
12/13/2022
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