MEDICARE: HEARTLAND ALLIANCE HEALTH

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	251B00000X	Case Management Agency
2	251S00000X	Community/Behavioral Health Agency	20	IL
3	251S00000X	Community/Behavioral Health Agency	020	IL
4	261QM0801X	Mental Health Clinic/Center (Including Community Mental Health Center)	020	IL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1588825749
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HEARTLAND ALLIANCE HEALTH

Provider Business Mailing Address
First Line	:	4750 N SHERIDAN RD STE 449
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60640-5078
Country	:	US
Telephone Number	:	773-751-4129
Fax Number	:	773-751-4175

Provider Business Practice Location Address
First Line	:	4750 N SHERIDAN ROAD
Second Line	:	SUITE 500
City	:	CHICAGO
State	:	IL
Zip	:	60640-5095
Country	:	US
Telephone Number	:	773-751-4125
Fax Number	:	773-751-4174

Authorized Official
Title or Position	:	EXECUTIVE DIRECTOR
Name	:	EDWARD STELLON
Credential	:
Telephone Number	:	312-405-0802

Provider Enumeration Date	:	06/20/2008
Last Update Date	:	04/27/2020

Similar Medicare Providers

1710414792 — DAVID ALLEN HONGISTO CADC
Practice Location Address:

4750 N SHERIDAN RD STE 500
CHICAGO, IL
60640-5095

Practice Phone: 773-751-4125
Practice Fax:

1174481642 — JOSEFINA RAMOS LARDUET
Practice Location Address:

2859 S PULASKI RD
CHICAGO, IL
60623-5095

Practice Phone: 234-225-4891
Practice Fax:

1033310909 — DR. KONSTANTIN UMANSKIY MD
Practice Location Address:

5841 S MARYLAND AVE , MC 5095
CHICAGO, IL
60637-1447

Practice Phone: 773-702-2026
Practice Fax: 773-834-1995

1831596980 — DR. MONICA CISNEROS D.C.
Practice Location Address:

2859 S PULASKI RD
CHICAGO, IL
60623-5095

Practice Phone: 773-762-3333
Practice Fax: 773-922-5203

1952855694 — LAURA ANN CRAWFORD
Practice Location Address:

5841 S MARYLAND AVE , MC 5095
CHICAGO, IL
60637-1447

Practice Phone: 773-702-4300
Practice Fax:

1306613252 — JOSEFINA RAMOS LARDUET
Practice Location Address:

2859 S PULASKI RD
CHICAGO, IL
60623-5095

Practice Phone: 815-558-9094
Practice Fax: 773-840-7394

Directions to “HEARTLAND ALLIANCE HEALTH ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.