Provider Demographics
NPI:1033601687
Name:ENVISION UNLIMITED
Entity Type:Organization
Organization Name:ENVISION UNLIMITED
Other - Org Name:DIVERSEY
Other - Org Type:Other Name
Authorized Official - Title/Position:DIRECTOR OF REVENUE CYCLE MGMT
Authorized Official - Prefix:
Authorized Official - First Name:NATALIE
Authorized Official - Middle Name:
Authorized Official - Last Name:BLIDER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:773-769-4313
Mailing Address - Street 1:5080 N ELSTON AVE
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60630-2459
Mailing Address - Country:US
Mailing Address - Phone:773-506-4313
Mailing Address - Fax:
Practice Address - Street 1:4434 W DIVERSEY AVE
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60639-1939
Practice Address - Country:US
Practice Address - Phone:773-506-3201
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ENVISION UNLIMITED
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2018-05-30
Last Update Date:2021-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)
No251C00000XAgenciesDay Training, Developmentally Disabled Services