NPIMap

Organization Active NPI

Healthe Land

  • Neurology Physician
  • Chicago, IL
National Provider Identifier
1013039866
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurology PhysicianTaxonomy code 2084N0400X
Legal business name
HEALTHE LAND
Practice address
4022 W 21St PL
2ND Floor
Chicago, IL 60623-2829
Phone
(773) 699-7630
Fax
(773) 751-2250
NPI assigned
Apr 4, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Mr. Etta Guest, PHD
Title
President
Phone
(773) 699-7630

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Neurology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 2084N0400X IL Primary

Addresses

Primary practice location

4022 W 21St PL
2ND Floor
Chicago, IL 60623-2829

Mailing address

4022 W 21St PL
Chicago, IL 60623-2829
Phone (773) 699-7630

National Provider Directory

National Provider Directory

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1175644800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1013039866",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4022 W 21ST PL",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606232829",
            "telephone_number": "773-699-7630",
            "fax_number": "773-751-2250"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4022 W 21ST PL",
            "address_2": "2ND FLOOR",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606232829",
            "telephone_number": "773-699-7630",
            "fax_number": "773-751-2250"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HEALTHE LAND",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-04",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "GUEST",
        "authorized_official_first_name": "ETTA",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "773-699-7630",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "PHD"
    },
    "taxonomies": [
        {
            "code": "2084N0400X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.