Organization
INTEGRATED HEALTHCARE CHICAGO LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SHARON L. SIDELL (ACTING OPERATING OFFICE)
(312) 497-9947
Entity
Organization
Contact information
Practice address
1044 N FRANCISCO AVE, CHICAGO, IL 60622-2743
(773) 292-8339
Mailing address
1044 N FRANCISCO AVE, CHICAGO, IL 60622-2743
(773) 292-8339
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
NONE
INTEGRATED HEALTH HOME
IL
Enumeration date
09/20/2018
Last updated
02/06/2019
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