NPIMap

Organization Active NPI

Chicago Family Health Center, Inc.

Doing business as Chicago Family Health Center

  • Federally Qualified Health Center (FQHC)
  • Chicago, IL
National Provider Identifier
1063614923
Registry record updated Oct 5, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
Legal business name
CHICAGO FAMILY HEALTH CENTER, INC.
Doing business as
Chicago Family Health Center
Practice address
570 E 115TH St
Chicago, IL 60628-5740
Phone
(773) 768-5000
Fax
(773) 840-3409
NPI assigned
Jun 4, 2007
Last updated
Oct 5, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 5, 2026

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

Authorized official

Name
Sherry Pace
Title
Chief Executive Officer
Phone
(773) 768-5000

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Federally Qualified Health Center (FQHC) 261QF0400X NU Primary

Addresses

Primary practice location

570 E 115TH St
Chicago, IL 60628-5740

Mailing address

9119 S Exchange Ave
Chicago, IL 60617-4225
Phone (773) 768-5000

Other identifiers 3

IdentifierTypeStateIssuer
14D0696915OtherILCLIA CERTIFICATE
7991OtherILCITY LICENSE
097001196OtherILCONTROL SUBSTANCE LICENSE

Other names 1

  • Chicago Family Health Center Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20040311000364 IL Part B Supplier - Clinic/Group Practice 6608765417 Receives reassigned benefits from 40 practitioners
5 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Chicago, IL
O20081107000750 IL Part A Provider - Federally Qualified Health Center (FQHC) 6608765417 Practice locations: Chicago, IL

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1063614923. Details of each certification follow.

Federally qualified health center certification: CCN 141833

Legal name
CHICAGO FAMILY HEALTH CENTER INC
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Jun 1, 1992
Last certification
Jun 1, 1992
Ownership / control type
For profit – corporation
Organization structure
CorporationNon-profit
Enrollment address
570 E 115TH St
Chicago, IL 60628-5740

Other NPIs with the same Medicare PAC ID 5

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

Other NPIs on the same Medicare enrollment 5

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
14D0696915Chicago Family Health Center-Pullman570 East 115TH St, Chicago, IL 60628Certificate of waiverNov 27, 2026

National Provider Directory

National Provider Directory

Locations

570 E 115th St
#340B577200
Chicago, IL 60628

Ownership & related parties

All disclosed owners & managing parties 9

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

NameRoleSinceShare
Elvia Perez Individual Corporate DirectorBoard Member Oct 13, 1992
Lyleth Rodriguez Individual Corporate DirectorBoard Member Jan 11, 1982
James Simmons Individual Corporate DirectorBoard Member Sep 15, 1998
Amelia Rodriguez Individual W-2 Managing EmployeeSenior Accountant Jun 23, 1981
Lupe Valadez Individual Corporate DirectorBoard Member Feb 10, 1977
Sherry Pace Individual Corporate OfficerChief Executive Officer Jul 1, 2022 100%
Operational/Managerial ControlCeo Jul 1, 2022 100%
Nora Reyes Individual Corporate DirectorBoard Member May 24, 2007
Mark Brummel Individual Corporate DirectorBoard Member Feb 10, 1977
Fulton Nolen Individual Corporate DirectorBoard Member Dec 17, 2013

Practitioners & affiliated clinicians

Practitioners 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1180915200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1791158400000",
    "number": "1063614923",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9119 S EXCHANGE AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606174225",
            "telephone_number": "773-768-5000",
            "fax_number": "773-768-6153"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "570 E 115TH ST",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606285740",
            "telephone_number": "773-768-5000",
            "fax_number": "773-840-3409"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHICAGO FAMILY HEALTH CENTER, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-06-04",
        "last_updated": "2026-10-05",
        "certification_date": "2026-10-05",
        "status": "A",
        "authorized_official_last_name": "PACE",
        "authorized_official_first_name": "SHERRY",
        "authorized_official_title_or_position": "CHIEF EXECUTIVE OFFICER",
        "authorized_official_telephone_number": "773-768-5000"
    },
    "taxonomies": [
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CLIA CERTIFICATE",
            "identifier": "14D0696915",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CITY LICENSE",
            "identifier": "7991",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CONTROL SUBSTANCE LICENSE",
            "identifier": "097001196",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Chicago Family Health Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.