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NPI 1629476635

NPI 1629476635 : AIDS HEALTHCARE FOUNDATION : CHICAGO, IL

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General NPI Number Information
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    NPI Number           |    1629476635
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    Entity Type          |    Organization 
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    Legal Business Name  |    AIDS HEALTHCARE FOUNDATION 
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Dates
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    Enumeration Date     |    12/08/2014
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    Last Update Date     |    09/11/2019
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Provider Practice Location Address
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    Address Line         |    2600 S MICHIGAN AVE SUITE LL-D
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    City                 |    CHICAGO
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    State                |    IL
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    Zip                  |    60616-2857
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    Country              |    US
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    Telephone            |    323-498-6665
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    Fax                  |    888-235-6638
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Provider Business Mailing Address
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    Address Line         |    6255 W SUNSET BLVD FL 21 
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    City                 |    LOS ANGELES
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    State                |    CA
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    Zip                  |    90028-7422
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    Country              |    US
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    Telephone            |    323-860-5200
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    Fax                  |    833-241-7615
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Authorized Official
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    Title or Position    |    CHIEF, MANAGED CARE
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    Name                 |     DONNA  STIDHAM 
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    Credential           |    
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    Telephone            |    323-436-5025
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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    Taxonomy Code        |    261Q00000X
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    Taxonomy Name        |    Clinic/Center
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    License Number       |    
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    License Number State |    
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