NPIMap

Organization Active NPI

Heartland International Health Center

  • Case Management Agency
  • Chicago, IL
National Provider Identifier
1972088615
Registry record updated Sep 28, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Case Management AgencyTaxonomy code 251B00000X
Legal business name
HEARTLAND INTERNATIONAL HEALTH CENTER
Practice address
3048 N Wilton Ave FL 2
Chicago, IL 60657-6710
Phone
(773) 296-7544
Fax
(773) 296-7637
NPI assigned
Sep 28, 2018
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 28, 2018

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

Authorized official

Name
Huell Lyle Collier
Title
Credentialing Manager
Phone
(773) 296-7544

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Case Management Agency 251B00000X Primary

Addresses

Primary practice location

3048 N Wilton Ave FL 2
Chicago, IL 60657-6710

Mailing address

3048 N Wilton Ave FL 2
Chicago, IL 60657-6710
Phone (773) 296-7544

Other identifiers 1

IdentifierTypeStateIssuer
63843377001MedicaidIL

National Provider Directory

National Provider Directory
Tax ID family
Heartland Health Centers24 organizations share this tax ID, including this one

Other organizations with this tax ID 23

Organizations that report the same tax identification number in the National Provider Directory.

View all 23

NPI Registry JSON

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

{
    "created_epoch": "1538092800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1538092800000",
    "number": "1972088615",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3048 N WILTON AVE FL 2",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606576710",
            "telephone_number": "773-296-7544",
            "fax_number": "773-296-7637"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3048 N WILTON AVE FL 2",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606576710",
            "telephone_number": "773-296-7544",
            "fax_number": "773-296-7637"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HEARTLAND INTERNATIONAL HEALTH CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-09-28",
        "last_updated": "2018-09-28",
        "status": "A",
        "authorized_official_last_name": "COLLIER",
        "authorized_official_first_name": "HUELL",
        "authorized_official_middle_name": "LYLE",
        "authorized_official_title_or_position": "CREDENTIALING MANAGER",
        "authorized_official_telephone_number": "773-296-7544"
    },
    "taxonomies": [
        {
            "code": "251B00000X",
            "taxonomy_group": "",
            "desc": "Case Management",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "63843377001",
            "state": "IL"
        }
    ],
    "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 Sep 28, 2018; 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.