Provider Demographics
NPI:1649466426
Name:HEALTHFRONT, LIMITED
Entity type:Organization
Organization Name:HEALTHFRONT, LIMITED
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:FRANCISCO
Authorized Official - Middle Name:L
Authorized Official - Last Name:CHUY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:773-267-0055
Mailing Address - Street 1:3610 W LAWRENCE AVE
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60625-5606
Mailing Address - Country:US
Mailing Address - Phone:773-267-1992
Mailing Address - Fax:
Practice Address - Street 1:3610 W LAWRENCE AVE
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60625-5606
Practice Address - Country:US
Practice Address - Phone:773-267-1992
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-09-14
Last Update Date:2012-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036087894207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL036087894Medicaid
IL210110Medicare PIN
ILK11273Medicare PIN