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General NPI Number Information
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NPI Number | 1861976532
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Entity Type | Organization
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Legal Business Name | MHN ACO, LLC
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Dates
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Enumeration Date | 09/19/2018
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Last Update Date | 10/05/2022
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Provider Practice Location Address
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Address Line | 180 N. STETSON AVENUE, SUITE 600-1 180 N. STETSON AVENUE, SUITE 600-1
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City | CHICAGO
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State | IL
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Zip | 60601
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Country | US
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Telephone | 312-274-0126
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Fax | 312-274-0555
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Provider Business Mailing Address
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Address Line | TWO PRUDENTIAL PLAZA 180 N. STETSON AVENUE, SUITE 600-1
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City | CHICAGO
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State | IL
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Zip | 60601
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Country | US
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Telephone | 312-274-0126
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Fax | 312-274-0555
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Authorized Official
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Title or Position | BOARD CHAIR
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Name | BRENDA WOLF
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Credential |
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Telephone | 773-394-9660
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251B00000X
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Taxonomy Name | Case Management Agency
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License Number |
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License Number State |
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