Provider Demographics
NPI:1326061458
Name:CHICAGO HEALTH INC.
Entity Type:Organization
Organization Name:CHICAGO HEALTH INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:ESTELITO
Authorized Official - Middle Name:T
Authorized Official - Last Name:MARTINEZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:773-478-7064
Mailing Address - Street 1:3701 N ELSTON AVE
Mailing Address - Street 2:2ND FLR
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60618-4309
Mailing Address - Country:US
Mailing Address - Phone:773-478-7064
Mailing Address - Fax:773-478-7136
Practice Address - Street 1:3701 N ELSTON AVE
Practice Address - Street 2:2ND FLR
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60618-4309
Practice Address - Country:US
Practice Address - Phone:773-478-7064
Practice Address - Fax:773-478-7136
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-26
Last Update Date:2007-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL1010513251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL147881Medicare UPIN
IL147881Medicare Oscar/Certification