Healthcare Provider Details

I. General information

NPI: 1831580588
Provider Name (Legal Business Name): HEALTHCARE ALTERNATIVE SYSTEMS, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/16/2015
Last Update Date: 02/21/2023
Certification Date: 02/21/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1915 W ROOSEVELT RD
BROADVIEW IL
60155-2925
US

IV. Provider business mailing address

4734 W CHICAGO AVE
CHICAGO IL
60651-3322
US

V. Phone/Fax

Practice location:
  • Phone: 708-334-7089
  • Fax: 708-334-7141
Mailing address:
  • Phone: 773-252-3100
  • Fax: 773-252-8945

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QR0405X
TaxonomySubstance Use Disorder Rehabilitation Clinic/Center
License NumberA-0589-O013-A
License Number StateIL

VIII. Authorized Official

Name: TOM HARTMANN
Title or Position: VP BUSINESS/IT
Credential:
Phone: 773-252-8945