Provider Demographics
NPI:1437327681
Name:HEARTLAND HUMAN CARE SERVICES
Entity Type:Organization
Organization Name:HEARTLAND HUMAN CARE SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:JOE
Authorized Official - Middle Name:
Authorized Official - Last Name:ANTOLIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:312-660-1341
Mailing Address - Street 1:208 S LASALLE ST
Mailing Address - Street 2:SUITE 1818
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60604-1000
Mailing Address - Country:US
Mailing Address - Phone:312-660-1341
Mailing Address - Fax:773-728-6929
Practice Address - Street 1:4411 N RAVENSWOOD AVE
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60640-5802
Practice Address - Country:US
Practice Address - Phone:773-728-5960
Practice Address - Fax:773-728-6929
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-02-11
Last Update Date:2008-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ILA24530003A251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health