Provider Demographics
NPI:1972663581
Name:2014 HEALTH LLC
Entity Type:Organization
Organization Name:2014 HEALTH LLC
Other - Org Name:CHICAGO BEHAVIORAL HOSPITAL PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:ALLEN
Authorized Official - Last Name:KRESCH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:212-243-5565
Mailing Address - Street 1:555 WILSON LN
Mailing Address - Street 2:
Mailing Address - City:DES PLAINES
Mailing Address - State:IL
Mailing Address - Zip Code:60016-4729
Mailing Address - Country:US
Mailing Address - Phone:847-768-5498
Mailing Address - Fax:847-768-5324
Practice Address - Street 1:555 WILSON LN
Practice Address - Street 2:
Practice Address - City:DES PLAINES
Practice Address - State:IL
Practice Address - Zip Code:60016-4729
Practice Address - Country:US
Practice Address - Phone:847-768-5498
Practice Address - Fax:847-768-5324
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-12
Last Update Date:2021-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL054018892333600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes333600000XSuppliersPharmacyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
2150748OtherPK
IL800865012002Medicaid