Healthcare Provider Details

I. General information

NPI: 1821790239
Provider Name (Legal Business Name): HEALTHCARE ALTERNATIVE SYSTEMS, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/20/2023
Last Update Date: 03/20/2023
Certification Date: 03/20/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4734 W CHICAGO AVE
CHICAGO IL
60651-3322
US

IV. Provider business mailing address

4734 W CHICAGO AVE
CHICAGO IL
60651-3322
US

V. Phone/Fax

Practice location:
  • Phone: 312-850-0050
  • Fax: 312-850-0085
Mailing address:
  • Phone: 312-850-0050
  • Fax: 312-850-0085

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number State

VIII. Authorized Official

Name: TOM HARTMANN
Title or Position: VP BUSINESS/IT
Credential:
Phone: 773-252-3100