Provider Demographics
NPI:1699846931
Name:ATLAS HEALTHCARE MANAGEMENT, INC
Entity Type:Organization
Organization Name:ATLAS HEALTHCARE MANAGEMENT, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:TREASURER
Authorized Official - Prefix:MR
Authorized Official - First Name:DONTAE
Authorized Official - Middle Name:
Authorized Official - Last Name:GREENFIELD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:773-585-4100
Mailing Address - Street 1:1027 CLINTON ST
Mailing Address - Street 2:
Mailing Address - City:OTTAWA
Mailing Address - State:IL
Mailing Address - Zip Code:61350-2039
Mailing Address - Country:US
Mailing Address - Phone:773-585-4100
Mailing Address - Fax:773-585-4147
Practice Address - Street 1:1027 CLINTON ST
Practice Address - Street 2:
Practice Address - City:OTTAWA
Practice Address - State:IL
Practice Address - Zip Code:61350-2039
Practice Address - Country:US
Practice Address - Phone:773-585-4100
Practice Address - Fax:773-585-4100
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-10
Last Update Date:2023-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL14D1021060251E00000X
251J00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
No251J00000XAgenciesNursing Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL147791Medicare ID - Type UnspecifiedHOME HEALTH AGENCY