| Heartland Alliance Health | |
|
4009 N Broadway St Chicago IL 60613-2110 | |
| (773) 275-2586 | |
| (773) 751-4175 |
| Full Name | Heartland Alliance Health |
|---|---|
| Speciality | Clinic/Center |
| Location | 4009 N Broadway St, Chicago, Illinois |
| Authorized Official Name and Position | Jimmy Valentin (SR. DIRECTOR, HEALTH INFORMATION SY) |
| Authorized Official Contact | 7732208562 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Heartland Alliance Health 4009 N Broadway St Chicago IL 60613-2110 Ph: (773) 275-2586 | Heartland Alliance Health 4009 N Broadway St Chicago IL 60613-2110 Ph: (773) 275-2586 |
| NPI Number | 1538294483 |
|---|---|
| Provider Enumeration Date | 02/22/2007 |
| Last Update Date | 04/01/2024 |
| Certification Date | 04/01/2024 |
| Medicare PECOS PAC ID | 5890696686 |
|---|---|
| Medicare Enrollment ID | O20040115000481 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1538294483 | NPI | - | NPPES |
| Provider Name | Mary Tornabene |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1730180621 PECOS PAC ID: 3678554920 Enrollment ID: I20040525000274 |
| Provider Name | Madhuri Thota |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1851425383 PECOS PAC ID: 0648258350 Enrollment ID: I20040709000636 |
| Provider Name | Michael C Dempsey |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1023082872 PECOS PAC ID: 7214974112 Enrollment ID: I20050412001177 |
| Provider Name | Caroline Thurlow |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1972760460 PECOS PAC ID: 0446310965 Enrollment ID: I20081113000470 |
| Provider Name | Kohar Jones |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1407969041 PECOS PAC ID: 4981765856 Enrollment ID: I20081210000606 |
| Provider Name | Colleen Ryan |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1235383274 PECOS PAC ID: 4688736879 Enrollment ID: I20081223000101 |
| Provider Name | Kortnee Y Roberson |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1972731172 PECOS PAC ID: 6103074398 Enrollment ID: I20120912000851 |
| Provider Name | Laura Verkest Dwyer |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1801020847 PECOS PAC ID: 1850523952 Enrollment ID: I20140403001339 |
| Provider Name | Philippe Tapon |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1013271618 PECOS PAC ID: 5193027779 Enrollment ID: I20160114000085 |
| Provider Name | Farqan Khan |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1548646755 PECOS PAC ID: 5799084315 Enrollment ID: I20200629000070 |
| Provider Name | Carolyn Alys Rydberg |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1356804439 PECOS PAC ID: 9436587268 Enrollment ID: I20200630000014 |
| Provider Name | Lorene Meyer |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1316637192 PECOS PAC ID: 7517315971 Enrollment ID: I20231122002341 |
| Provider Name | Brian Truncale |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1912397316 PECOS PAC ID: 0143766402 Enrollment ID: I20240723000953 |
| Provider Name | Hannah Paul |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1114701208 PECOS PAC ID: 1850838186 Enrollment ID: I20240805003179 |
| Provider Name | Yukako Ishiguro Sortino |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1649047036 PECOS PAC ID: 9830620723 Enrollment ID: I20241002002939 |
| Provider Name | Ashley Allen |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1265830970 PECOS PAC ID: 1557893161 Enrollment ID: I20241021000442 |
| Provider Name | Enrique Zaragoza |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1861219412 PECOS PAC ID: 7719414960 Enrollment ID: I20241230000821 |
| Provider Name | Bethany Judson |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1124884754 PECOS PAC ID: 7810425469 Enrollment ID: I20250109002126 |
| Provider Name | Jasmine L Crosby |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1811704349 PECOS PAC ID: 2062940422 Enrollment ID: I20250113002179 |
Philip K Mccullough Md Sc Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 201 E Huron St, Suite 11-100, Chicago, IL 60611 Phone: 312-695-3680 Fax: 312-926-3709 | |
Amy Lynn, Lcpc, Atr Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 3020 N Lincoln Ave, Flourish Studios, Chicago, IL 60657 Phone: 773-746-7429 | |
K.a.m Alliance, Inc. Mental Health Clinic Medicare: Medicare Enrolled Practice Location: 2215 W 95th St Ste 100, Chicago, IL 60643 Phone: 773-239-9600 Fax: 773-239-9601 | |
King Community Mental Health Center Corp Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 4455 S King Drive, Suite 101, Chicago, IL 60653 Phone: 773-536-2700 Fax: 773-751-2250 | |
The Thresholds Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 4219 N Lincoln Ave, Chicago, IL 60618 Phone: 773-572-5500 Fax: 773-537-3488 | |
Professional Diagnostic Service, S.c. Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 821 W Van Buren St, Chicago, IL 60607 Phone: 312-491-0404 Fax: 312-491-0505 | |
Universal Medical Group Ltd. Mental Health Clinic Medicare: Not Enrolled in Medicare Practice Location: 809 E 42nd Pl, Chicago, IL 60653 Phone: 773-285-3422 |