Organization
TAPESTRY 360 HEALTH
Active
Organization
TAPESTRY 360 HEALTH
Active
Other names
Tapestry 360 Health - Roosevelt High School, Heartland Health Centers
Organization subpart
No
Provider details
NPI number
Authorized official
NICOLE WILLIS (CEO)
(773) 751-7800
Entity
Organization
Contact information
Practice address
3436 WEST WILSON AVENUE, CHICAGO, IL 60625-5318
(773) 866-0818
(773) 866-9069
Mailing address
1301 W DEVON AVE, CHICAGO, IL 60660-1329
(773) 751-7800
(773) 634-7962
Taxonomy
Speciality
Code
Description
License number
State
261QF0400X
Federally Qualified Health Center (FQHC)
Primary
—
—
363LC1500X
Community Health Nurse Practitioner
004
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
004
—
IL
Enumeration date
05/22/2008
Last updated
10/04/2023
Update your record
If you believe information in your NPPES record is inaccurate, or if you wish to update or deactivate your NPI, you can do so directly with CMS at https://nppes.cms.hhs.gov.
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Sign up