Provider Demographics
NPI:1447716568
Name:PATHOS CHICAGO LLC
Entity type:Organization
Organization Name:PATHOS CHICAGO LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:FOUNDER
Authorized Official - Prefix:
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:
Authorized Official - Last Name:HILLIKER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:713-470-9878
Mailing Address - Street 1:430 W ERIE ST STE 205
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60654-7692
Mailing Address - Country:US
Mailing Address - Phone:312-584-6635
Mailing Address - Fax:
Practice Address - Street 1:430 W ERIE ST STE 205
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60654-7692
Practice Address - Country:US
Practice Address - Phone:312-792-3610
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:THE LOVETT CENTER LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2019-02-13
Last Update Date:2021-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QR0405XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation, Substance Use Disorder
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Multi-Specialty
No104100000XBehavioral Health & Social Service ProvidersSocial WorkerGroup - Multi-Specialty
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty