Organization
360 ACTIVE RECOVERY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JULIUS HEARN (CEO)
(872) 203-3500
Entity
Organization
Contact information
Practice address
2221 W NORTH AVE, #1, CHICAGO, IL 60647-5429
(872) 203-3500
Mailing address
2221 W. NORTH AVE, CHICAGO, IL 60647
(872) 203-3500
Taxonomy
Speciality
Code
Description
License number
State
261QH0100X
Health Service Clinic/Center
Primary
2487457
IL
Other
Enumeration date
10/19/2016
Last updated
10/19/2016
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