MEDICARE: TRILOGY INC.

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
1	251S00000X	Community/Behavioral Health Agency

General Provider Information

NPI Number	:	1376392787
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	TRILOGY INC.

Provider Business Mailing Address
First Line	:	1400 W GREENLEAF AVE
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60626-2805
Country	:	US
Telephone Number	:	815-650-0886
Fax Number	:

Provider Business Practice Location Address
First Line	:	6200 N HIAWATHA AVE
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60646-4309
Country	:	US
Telephone Number	:	773-508-6100
Fax Number	:

Authorized Official
Title or Position	:	CREDENTIALING COORDINATOR
Name	:	JOSEPH SEELOW
Credential	:
Telephone Number	:	815-650-0886

Provider Enumeration Date	:	05/16/2024
Last Update Date	:	05/16/2024

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Directions to “TRILOGY INC. ” Practice Location

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