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
2	261QM0801X	Mental Health Clinic/Center (Including Community Mental Health Center)

General Provider Information

NPI Number	:	1942700083
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	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	4534 S WESTERN AVE
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60609-3027
Country	:	US
Telephone Number	:	773-508-6100
Fax Number	:

Authorized Official
Title or Position	:	CFO
Name	:	RICHARD ADELMAN
Credential	:
Telephone Number	:	815-901-6866

Provider Enumeration Date	:	02/15/2018
Last Update Date	:	02/23/2021

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Directions to “TRILOGY, INC. ” Practice Location

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