Provider Demographics
NPI:1376138610
Name:HEALTHY HEARTS & WELLNESS
Entity Type:Organization
Organization Name:HEALTHY HEARTS & WELLNESS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:NP
Authorized Official - Prefix:
Authorized Official - First Name:ANGELA
Authorized Official - Middle Name:
Authorized Official - Last Name:BEAL
Authorized Official - Suffix:
Authorized Official - Credentials:NP
Authorized Official - Phone:773-414-7352
Mailing Address - Street 1:2136 W 95TH ST STE 201
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60643-1000
Mailing Address - Country:US
Mailing Address - Phone:708-808-0540
Mailing Address - Fax:
Practice Address - Street 1:2136 W 95TH ST STE 201
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60643-1000
Practice Address - Country:US
Practice Address - Phone:708-808-0540
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:HEALTHY HEARTS WELLNESS
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2021-03-09
Last Update Date:2021-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center