NPIMap

Organization Active NPI

Family Christian Health Center

  • Federally Qualified Health Center (FQHC)
  • Harvey, IL
National Provider Identifier
1093855736
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
Practice address
31 W 155TH St
Harvey, IL 60426-3556
Phone
(708) 596-5177
Fax
(708) 339-3583
NPI assigned
Feb 8, 2007
Last updated
Jul 16, 2025By the provider in NPPES
Organization subpart
No

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
Dr. Lisa Green, MDNPI 1114973062
Title
Ceo
Phone
(708) 596-5177

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Federally Qualified Health Center (FQHC) 261QF0400X Primary
General Practice Dentistry 1223G0001X
Obstetrics & Gynecology Physician 207V00000X
General Practice Physician 208D00000X

Addresses

Primary practice location

31 W 155TH St
Harvey, IL 60426-3556

Mailing address

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

Medicare participation

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

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20040325000572 IL Part B Supplier - Clinic/Group Practice 6507758612 Receives reassigned benefits from 43 practitioners
3 other NPIs on this enrollment
Practice locations: Harvey, IL; Lynwood, IL; Dolton, IL
O20110609000103 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 1093855736. Details of each certification follow.

Federally qualified health center certification: CCN 141002

Legal name
FAMILY CHRISTIAN HEALTH CENTER
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Feb 2, 2005
Last certification
Feb 2, 2005
Ownership / control type
Non-profit – other
Organization structure
CorporationNon-profit
Enrollment address
31 W 155TH St
Harvey, IL 60426-3556

Other NPIs with the same Medicare PAC ID 4

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

Other NPIs on the same Medicare enrollment 3

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

National Provider Directory

National Provider Directory

Locations

713 E 142nd St
Dolton, IL 60419
Phone (708) 596-5177

31 W 155th St
Ste A
Harvey, IL 60426

31 W 155th St
Ste E
Harvey, IL 60426

Ownership & related parties

All disclosed owners & managing parties 6

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 DirectorBoard Member Jan 1, 2014
Deane Taylor Individual Corporate OfficerBoard Member Oct 1, 2024
Karen Jacobs Individual Corporate DirectorBoard President Jan 1, 2013
Lisa J Green Individual Corporate OfficerCeo Oct 1, 2001 100%
Operational/Managerial Control Oct 1, 2018
Kimberly Jones-Saunders Individual Corporate OfficerBoard Member Jan 1, 2013
Kenneth McGhee Individual Corporate DirectorBoard Treasurer Jan 1, 2013

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

    Corporate Officer, Operational/Managerial Control

    CMS ownership

Practitioners & affiliated clinicians

Practitioners 53

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 53

NPI Registry JSON

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

{
    "created_epoch": "1170892800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1752624000000",
    "number": "1093855736",
    "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": "708-339-3583"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "31 W 155TH ST",
            "city": "HARVEY",
            "state": "IL",
            "postal_code": "604263556",
            "telephone_number": "708-596-5177",
            "fax_number": "708-339-3583"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FAMILY CHRISTIAN HEALTH CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-08",
        "last_updated": "2025-07-16",
        "certification_date": "2025-07-16",
        "status": "A",
        "authorized_official_last_name": "GREEN",
        "authorized_official_first_name": "LISA",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "708-596-5177",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Harvey, IL

Sources for this page

Verify at the official NPI Registry.