MEDICARE: HEALTHCARE ALTERNATIVE SYSTEMS, 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	261QM0801X	Mental Health Clinic/Center (Including Community Mental Health Center)	12001	IL

General Provider Information

NPI Number	:	1992138325
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HEALTHCARE ALTERNATIVE SYSTEMS, INC

Provider Business Mailing Address
First Line	:	4734 W CHICAGO AVE
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60651-3322
Country	:	US
Telephone Number	:	773-252-3100
Fax Number	:	773-252-8945

Provider Business Practice Location Address
First Line	:	5005 W FULLERTON AVE
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60639-2413
Country	:	US
Telephone Number	:	773-745-7107
Fax Number	:	773-745-9902

Authorized Official
Title or Position	:	CEO
Name	:	MARCO JACOME
Credential	:
Telephone Number	:	773-252-3100

Provider Enumeration Date	:	08/21/2013
Last Update Date	:	02/21/2023

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