Healthcare Provider Details

I. General information

NPI: 1336631977
Provider Name (Legal Business Name): ENVISION UNLIMITED
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/30/2018
Last Update Date: 03/21/2025
Certification Date: 03/21/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6529 N FAIRFIELD AVE
CHICAGO IL
60645-4410
US

IV. Provider business mailing address

8 S MICHIGAN AVE STE 1700
CHICAGO IL
60603-3353
US

V. Phone/Fax

Practice location:
  • Phone: 773-801-7602
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code320800000X
TaxonomyMental Illness Community Based Residential Treatment Facility
License Number
License Number State
# 4
Primary TaxonomyY
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number18004
License Number StateIL

VIII. Authorized Official

Name: NATALIE BLIDER
Title or Position: DIR. OF RCM- MH
Credential:
Phone: 773-506-3014