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NPI Code Detail

MEDICARE: HEURISTIC QUEST HEADQUARTERS

MEDICARE: HEURISTIC QUEST HEADQUARTERS
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101YA0400XAddiction (Substance Use Disorder) Counselor
2251S00000XCommunity/Behavioral Health Agency
3363LP0808XPsychiatric/Mental Health Nurse Practitioner
4261QF0400XFederally Qualified Health Center (FQHC)
5261QR0405XSubstance Use Disorder Rehabilitation Clinic/Center
6101YP2500XProfessional Counselor

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1A-7476-0001-AOTHERILSUPR LICENSE

General Provider Information

NPI Number : 1063822823
Entity Type Code : Organization
Provider Name (Legal Business Name) : HEURISTIC QUEST HEADQUARTERS
Provider Business Mailing Address
First Line : 1708 W BEVERLY GLEN PKWY
Second Line :
City : CHICAGO
State : IL
Zip : 60643-1408
Country : US
Telephone Number : 773-238-5555
Fax Number : 773-238-5533
Provider Business Practice Location Address
First Line : 1222 W. 95TH ST
Second Line :
City : CHICAGO
State : IL
Zip : 60643-1408
Country : US
Telephone Number : 773-238-5555
Fax Number : 773-238-5533
Authorized Official
Title or Position : EXECUTIVE DIRECTOR
Name : MRS. PAULETTE R. EASON-WILLIAMS
Credential : LCPC CADC
Telephone Number : 773-238-5555
Provider Enumeration Date : 05/02/2014
Last Update Date : 02/15/2026

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Directions to “HEURISTIC QUEST HEADQUARTERS ” Practice Location

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