Provider Demographics
NPI:1619656832
Name:HEART OF HEALTH PLLC
Entity type:Organization
Organization Name:HEART OF HEALTH PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JACK
Authorized Official - Middle Name:M
Authorized Official - Last Name:PHAM
Authorized Official - Suffix:
Authorized Official - Credentials:DNP, APRN, FNP-BC
Authorized Official - Phone:773-455-4325
Mailing Address - Street 1:7709 NILES CENTER RD
Mailing Address - Street 2:
Mailing Address - City:SKOKIE
Mailing Address - State:IL
Mailing Address - Zip Code:60077-2768
Mailing Address - Country:US
Mailing Address - Phone:773-455-4325
Mailing Address - Fax:773-838-0902
Practice Address - Street 1:4947 N WINTHROP
Practice Address - Street 2:MEDICAL CENTER FLR 1
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60640
Practice Address - Country:US
Practice Address - Phone:773-455-4325
Practice Address - Fax:773-838-0902
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-07-14
Last Update Date:2025-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGroup - Single Specialty