Healthcare Provider Details

I. General information

NPI: 1649466426
Provider Name (Legal Business Name): HEALTHFRONT, LIMITED
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/14/2007
Last Update Date: 01/26/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3610 W LAWRENCE AVE
CHICAGO IL
60625-5606
US

IV. Provider business mailing address

3610 W LAWRENCE AVE
CHICAGO IL
60625-5606
US

V. Phone/Fax

Practice location:
  • Phone: 773-267-1992
  • Fax:
Mailing address:
  • Phone: 773-267-1992
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number036087894
License Number StateIL

VIII. Authorized Official

Name: FRANCISCO L CHUY
Title or Position: PRESIDENT
Credential: MD
Phone: 773-267-0055