Organization
HEARTLAND ALLIANCE HEALTH
Active
Other names
Heartland Health Outreach, Heartland Health Outreach Pathway
Organization subpart
No
Provider details
NPI number
Authorized official
JIMMY VALENTIN (DIRECTOR, REVENUE CYCLE MANAGEMENT)
(773) 751-4129
Entity
Organization
Contact information
Practice address
1015 W LAWRENCE AVE, CHICAGO, IL 60640-5017
(773) 751-4129
(773) 751-4175
Mailing address
4750 N SHERIDAN RD STE 449, CHICAGO, IL 60640-5078
(773) 751-4129
(773) 751-4175
Taxonomy
Speciality
Code
Description
License number
State
261QR0405X
Substance Use Disorder Rehabilitation Clinic/Center
Primary
077560001
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
022
—
IL
Enumeration date
05/21/2008
Last updated
11/17/2020
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