Healthcare Provider Details

I. General information

NPI: 1972039568
Provider Name (Legal Business Name): TRILOGY, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/03/2017
Last Update Date: 02/23/2021
Certification Date: 02/23/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2551 W PETERSON AVE
CHICAGO IL
60659
US

IV. Provider business mailing address

1400 W GREENLEAF AVE
CHICAGO IL
60626-2805
US

V. Phone/Fax

Practice location:
  • Phone: 773-508-6100
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number04138
License Number StateIL

VIII. Authorized Official

Name: RICH ADELMAN
Title or Position: CFO
Credential:
Phone: 773-382-4002