Provider Demographics
NPI:1386117232
Name:PRUDENT ALLIANCE FOR HEALTHCARE, LLC
Entity type:Organization
Organization Name:PRUDENT ALLIANCE FOR HEALTHCARE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:JULITO
Authorized Official - Middle Name:
Authorized Official - Last Name:YRANELA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:773-850-4749
Mailing Address - Street 1:6159 W EDDY ST
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60634-4122
Mailing Address - Country:US
Mailing Address - Phone:630-425-2570
Mailing Address - Fax:630-425-2547
Practice Address - Street 1:6159 W EDDY ST
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60634-4122
Practice Address - Country:US
Practice Address - Phone:630-425-2570
Practice Address - Fax:630-425-2547
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-01-03
Last Update Date:2019-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Single Specialty