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General NPI Number Information
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NPI Number | 1144827320
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Entity Type | Organization
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Legal Business Name | ENVISION UNLIMITED
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Dates
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Enumeration Date | 10/01/2020
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Last Update Date | 10/01/2020
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Provider Practice Location Address
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Address Line | 4919 N CLARK ST
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City | CHICAGO
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State | IL
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Zip | 60640-3514
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Country | US
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Telephone | 773-769-2139
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Fax |
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Provider Business Mailing Address
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Address Line | 5080 N ELSTON AVE
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City | CHICAGO
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State | IL
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Zip | 60630-2459
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Country | US
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Telephone | 303-667-9772
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Fax |
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Authorized Official
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Title or Position | DIRECTOR OF REVENUE CYCLE MGMT
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Name | NATALIE BLIDER
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Credential |
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Telephone | 303-667-9772
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0801X
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Taxonomy Name | Mental Health Clinic/Center (Including Community Mental Health Center)
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License Number |
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License Number State |
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