NPIMap

Organization Active NPI

Access Community Health Network

  • Federally Qualified Health Center (FQHC)
  • Chicago, IL
National Provider Identifier
1104995034
Registry record updated Jan 26, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
Legal business name
ACCESS COMMUNITY HEALTH NETWORK
Practice address
400 E 41St St
Chicago, IL 60653-3071
Phone
(773) 624-2660
NPI assigned
Nov 7, 2006
Last updated
Jan 26, 2011By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 26, 2011

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

Authorized official

Name
Donna Thompson
Title
Ceo
Phone
(312) 526-2200

Specialties & licenses 1

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

Addresses

Primary practice location

400 E 41St St
Chicago, IL 60653-3071

Mailing address

222 N Canal St
Chicago, IL 60606-1206
Phone (312) 526-2200

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20031204000985 IL Part B Supplier - Clinic/Group Practice 9537076112 Receives reassigned benefits from 512 practitioners
This NPI is an additional NPI on the enrollment
Practice locations: Chicago, IL; Chicago Heights, IL; Cicero, IL; Des Plaines, IL; Evanston, IL; Heights, IL; Melrose Park, IL; Summit, IL…

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1104995034. Details of each certification follow.

  • CCN 141029 Federally qualified health center · Active · Name & address match · Details

Federally qualified health center certification: CCN 141029

Name & address match This certification has no NPI in the Medicare enrollment files. CMS publishes enrollment files for six facility types only, so it was connected to this NPI by matching the name and address CMS publishes for it.

Legal name
ACCESS COMMUNITY HEALTH NETWORK
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
May 8, 2006
Last certification
May 8, 2006
Ownership / control type
For profit – corporation
Facility address
400 East 41St Street
Chicago, IL 60653
Related CCNs
141867

National Provider Directory

National Provider Directory

Locations

222 N Canal St
Chicago, IL 60606
Phone (773) 826-6600

NPI Registry JSON

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

{
    "created_epoch": "1162857600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1296000000000",
    "number": "1104995034",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "222 N CANAL ST",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606061206",
            "telephone_number": "312-526-2200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 E 41ST ST",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606533071",
            "telephone_number": "773-624-2660"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ACCESS COMMUNITY HEALTH NETWORK",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-07",
        "last_updated": "2011-01-26",
        "status": "A",
        "authorized_official_last_name": "THOMPSON",
        "authorized_official_first_name": "DONNA",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "312-526-2200"
    },
    "taxonomies": [
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.