Provider Demographics
NPI:1720756646
Name:HALLMARK HEALTHCARE SERVICES INC.
Entity Type:Organization
Organization Name:HALLMARK HEALTHCARE SERVICES INC.
Other - Org Name:HALLMARK HEALTHCARE SERVICES INC.
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:ADAEZE
Authorized Official - Middle Name:
Authorized Official - Last Name:ULOGO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:773-337-8654
Mailing Address - Street 1:2320 W ARTHUR AVE APT 1
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60645-5480
Mailing Address - Country:US
Mailing Address - Phone:773-979-1979
Mailing Address - Fax:
Practice Address - Street 1:2320 W ARTHUR AVE APT 1
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60645-5480
Practice Address - Country:US
Practice Address - Phone:773-979-1979
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-09-03
Last Update Date:2024-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes376J00000XNursing Service Related ProvidersHomemakerGroup - Multi-Specialty
No374U00000XNursing Service Related ProvidersHome Health AideGroup - Multi-Specialty
No376K00000XNursing Service Related ProvidersNurse's AideGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL42011879306Medicaid