NPIMap

Organization Active NPI

Howard Brown Health Center

  • Federally Qualified Health Center (FQHC)
  • Chicago, IL
National Provider Identifier
1154856870
Registry record updated Apr 10, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
Legal business name
HOWARD BROWN HEALTH CENTER
Practice address
641 W 63Rd St BSMT
Chicago, IL 60621-2032
Phone
(773) 388-1600
Fax
(773) 388-8936
NPI assigned
May 1, 2017
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 10, 2025

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

Authorized official

Name
Burgundy Johnson
Title
Credentialing
Phone
(872) 629-3491

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
DentistGroup: 193200000X MULTI-SPECIALTY GROUP 122300000X
General Practice DentistryGroup: 193200000X MULTI-SPECIALTY GROUP 1223G0001X
Pediatric DentistryGroup: 193200000X MULTI-SPECIALTY GROUP 1223P0221X
Federally Qualified Health Center (FQHC) 261QF0400X Primary

Addresses

Primary practice location

641 W 63Rd St BSMT
Chicago, IL 60621-2032

Mailing address

4025 N Sheridan Rd
Chicago, IL 60613-2010
Phone (773) 388-1600

Other names 1

  • Howard Brown Health 63rd St Oral Health Services Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Howard Brown Health Cen7 organizations share this tax ID, including this one

Other organizations with this tax ID 6

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

Locations

641 W 63rd St
Bsmt
Chicago, IL 60621

NPI Registry JSON

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

{
    "created_epoch": "1493596800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1744243200000",
    "number": "1154856870",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4025 N SHERIDAN RD",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606132010",
            "telephone_number": "773-388-1600"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "641 W 63RD ST BSMT",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606212032",
            "telephone_number": "773-388-1600",
            "fax_number": "773-388-8936"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HOWARD BROWN HEALTH CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-05-01",
        "last_updated": "2025-04-10",
        "certification_date": "2025-04-10",
        "status": "A",
        "authorized_official_last_name": "JOHNSON",
        "authorized_official_first_name": "BURGUNDY",
        "authorized_official_title_or_position": "CREDENTIALING",
        "authorized_official_telephone_number": "872-629-3491"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1223P0221X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, Pediatric Dentistry",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Howard Brown Health 63rd St Oral Health Services",
            "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 Apr 10, 2025; 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.