NPIMap

Organization Active NPI

Infant Welfare Society of Chgo

Doing business as Angel Harvey Family Health Center

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Chicago, IL
National Provider Identifier
1053567966
Registry record updated Sep 10, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X
Legal business name
INFANT WELFARE SOCIETY OF CHGO
Doing business as
Angel Harvey Family Health Center
Practice address
3600 W Fullerton Ave
Chicago, IL 60647-2319
Phone
(773) 782-2800
Fax
(773) 782-5042
NPI assigned
Aug 12, 2008
Reactivated
Sep 10, 2024
Last updated
Sep 10, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 10, 2024

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

Authorized official

Name
Jose Galarza
Title
Chief Healthcare Analytics Officer
Phone
(773) 782-5035

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Clinic/Center (Including Community Mental Health Center) 261QM0801X NU Primary
Community/Behavioral Health Agency 251S00000X 002 IL

Addresses

Primary practice location

3600 W Fullerton Ave
Chicago, IL 60647-2319

Mailing address

3600 W Fullerton Ave
Chicago, IL 60647-2319
Phone (773) 782-2800

Other names 1

  • Angel Harvey Family Health Center Doing business as

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address paola.portela.1@17986.direct.athenahealth.com Direct

National Provider Directory

National Provider Directory
Tax ID family
Infant Welfare Society of Chgo4 organizations share this tax ID, including this one

Other organizations with this tax ID 3

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

NPI Registry JSON

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

{
    "created_epoch": "1218499200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1725926400000",
    "number": "1053567966",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3600 W FULLERTON AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606472319",
            "telephone_number": "773-782-2800",
            "fax_number": "773-782-5056"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3600 W FULLERTON AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606472319",
            "telephone_number": "773-782-2800",
            "fax_number": "773-782-5042"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INFANT WELFARE SOCIETY OF CHGO",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-08-12",
        "last_updated": "2024-09-10",
        "certification_date": "2022-03-25",
        "deactivation_date": "2024-09-03",
        "reactivation_date": "2024-09-10",
        "status": "A",
        "authorized_official_last_name": "GALARZA",
        "authorized_official_first_name": "JOSE",
        "authorized_official_title_or_position": "CHIEF HEALTHCARE ANALYTICS OFFICER",
        "authorized_official_telephone_number": "773-782-5035"
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "IL",
            "license": "002",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "paola.portela.1@17986.direct.athenahealth.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "3600 W Fullerton Ave",
            "city": "Chicago",
            "state": "IL",
            "country_code": "US",
            "postal_code": "606472319",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "Angel Harvey Family Health Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Chicago, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 10, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.