Healthcare Provider Details

I. General information

NPI: 1134944754
Provider Name (Legal Business Name): 1103 HEALTH PARTNERS, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/19/2024
Last Update Date: 09/30/2025
Certification Date: 09/30/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1585 N MILWAUKEE AVE STE 105
LIBERTYVILLE IL
60048-1359
US

IV. Provider business mailing address

1585 N MILWAUKEE AVE STE 105
LIBERTYVILLE IL
60048-1359
US

V. Phone/Fax

Practice location:
  • Phone: 847-433-5650
  • Fax:
Mailing address:
  • Phone: 847-433-5650
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251G00000X
TaxonomyCommunity Based Hospice Care Agency
License Number
License Number State

VIII. Authorized Official

Name: STEVEN JAMES ALESSANDRO
Title or Position: CEO
Credential: PSYD
Phone: 847-457-1808