NPIMap

Organization Active NPI

Family Christian Health Center

Doing business as FCHC-Integrative Health and Wellness Center

  • Federally Qualified Health Center (FQHC)
  • Harvey, IL
National Provider Identifier
1013744325
Registry record updated Jul 16, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
Legal business name
FAMILY CHRISTIAN HEALTH CENTER
Doing business as
FCHC-Integrative Health and Wellness Center
Family Christian Health Center Integrative Health and Wellness Center
Practice address
26 W 154TH St
Harvey, IL 60426-3539
Phone
(708) 596-5177
Fax
(708) 596-5518
NPI assigned
Sep 19, 2024
Last updated
Jul 16, 2025By the provider in NPPES
Organization subpart
Yes
Parent organization
FAMILY CHRISTIAN HEALTH CENTERAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jul 16, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Jacqueline Y Donaldson
Title
Credentialing
Phone
(708) 596-5177

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Federally Qualified Health Center (FQHC) 261QF0400X NU Primary
Health Educator 174H00000X NU
Obesity and Weight Management Nutrition Registered Dietitian 133VN1201X NU

Addresses

Primary practice location

26 W 154TH St
Harvey, IL 60426-3539

Mailing address

31 W 155TH St
Harvey, IL 60426-3556
Phone (708) 596-5177

Other names 2

  • FCHC-Integrative Health and Wellness Center Doing business as
  • Family Christian Health Center Integrative Health and Wellness Center Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20250507001832 IL Part A Provider - Federally Qualified Health Center (FQHC) 6507758612 Practice locations: Harvey, IL

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1013744325. Details of each certification follow.

Federally qualified health center certification: CCN C41047

Legal name
FAMILY CHRISTIAN HEALTH CENTER
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
May 5, 2025
Last certification
May 5, 2025
Ownership / control type
For profit – corporation
Organization structure
CorporationNon-profit
Enrollment address
26 W 154TH St
Harvey, IL 60426-3539

Other NPIs with the same Medicare PAC ID 4

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

National Provider Directory

National Provider Directory
Tax ID family
Family Christian Health Center7 organizations share this tax ID, including this one
Part of
Family Christian Health Center

Other organizations with this tax ID 6

Organizations that report the same tax identification number in the National Provider Directory.

Locations

31 W 155th St
Harvey, IL 60426
Phone (708) 596-5177

19767 Torrence Ave
Lynwood, IL 60411
Phone (708) 596-5177

Ownership & related parties

All disclosed owners & managing parties 5

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Vernice Davis-Clark Individual Corporate OfficerBoard Member Jan 1, 2025
Karen Jacobs Individual Corporate OfficerBoard President Jan 1, 2025
Lisa J Green Individual 5% Or Greater Direct Ownership InterestCeo Apr 1, 2025
Corporate OfficerCeo Apr 1, 2000 100%
Operational/Managerial ControlCeo Jan 1, 2025 100%
Kimberly Jones-Saunders Individual Corporate OfficerBoard Member Jan 1, 2024
Kenneth McGhee Individual Corporate OfficerBoard Member Jan 1, 2025

Owners & managing parties with NPI records 1

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

  • Lisa J Green
    • Family Medicine Physician
    • Harvey, IL
    • NPI 1114973062

    5% Or Greater Direct Ownership Interest, Corporate Officer, Operational/Managerial Control

    CMS ownership

Practitioners & affiliated clinicians

Practitioners 40

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 40

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1726704000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1752624000000",
    "number": "1013744325",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "31 W 155TH ST",
            "city": "HARVEY",
            "state": "IL",
            "postal_code": "604263556",
            "telephone_number": "708-596-5177",
            "fax_number": "708-596-5518"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "26 W 154TH ST",
            "city": "HARVEY",
            "state": "IL",
            "postal_code": "604263539",
            "telephone_number": "708-596-5177",
            "fax_number": "708-596-5518"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FAMILY CHRISTIAN HEALTH CENTER",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "FAMILY CHRISTIAN HEALTH CENTER",
        "enumeration_date": "2024-09-19",
        "last_updated": "2025-07-16",
        "certification_date": "2025-07-16",
        "status": "A",
        "authorized_official_last_name": "DONALDSON",
        "authorized_official_first_name": "JACQUELINE",
        "authorized_official_middle_name": "Y",
        "authorized_official_title_or_position": "CREDENTIALING",
        "authorized_official_telephone_number": "708-596-5177"
    },
    "taxonomies": [
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "174H00000X",
            "taxonomy_group": "",
            "desc": "Health Educator",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "133VN1201X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered, Nutrition, Obesity and Weight Management",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "FCHC-Integrative Health and Wellness Center",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Family Christian Health Center Integrative Health and Wellness Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Harvey, IL

Sources for this page

Verify at the official NPI Registry.