Access Community Health Network

Organization Active NPI Federally Qualified Health Center (FQHC) · Chicago, IL

NPI 1124152657 · NPPES record last updated Jan 26, 2011

Key facts

NPI
1124152657
Entity type
Organization (NPI type 2)
Primary specialty
Federally Qualified Health Center (FQHC) 261QF0400X
Legal business name
ACCESS COMMUNITY HEALTH NETWORK
Practice address
6130 S Wolcott Ave
Chicago, IL 60636-2100
Phone
(773) 434-3856
NPI assigned
Mar 15, 2007
Organization subpart
No

Authorized official

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

Medicare participation

Medicare fee-for-service enrollment
Enrolled in IL

Medicare enrollment records

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…

National Provider Directory

Specialties & licenses

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

Addresses

Primary practice location

6130 S Wolcott Ave
Chicago, IL 60636-2100

Mailing address

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

Other providers in Chicago, IL

All providers in Chicago, IL · Federally Qualified Health Center (FQHC) in Illinois

Sources for this page

Verify at the official NPI Registry.