Provider Demographics
NPI:1144511379
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:JOSEPH
Authorized Official - Middle Name:
Authorized Official - Last Name:ANTOLIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:312-660-1341
Mailing Address - Street 1:1525 E HYDE PARK BLVD
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60615-3043
Mailing Address - Country:US
Mailing Address - Phone:773-624-6148
Mailing Address - Fax:773-326-0580
Practice Address - Street 1:1525 E HYDE PARK BLVD
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60615-3043
Practice Address - Country:US
Practice Address - Phone:773-624-6148
Practice Address - Fax:773-326-0580
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-04-21
Last Update Date:2011-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL1490095341041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty