Access Community Health Network

Primary specialty

Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X

Legal business name

ACCESS COMMUNITY HEALTH NETWORK

Practice address

526 Main St
West Chicago, IL 60185-2843

Phone

(773) 257-6770

NPI assigned

Sep 9, 2009

Last updated

Jan 26, 2011By the provider in NPPES

Organization subpart

No

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

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1184957151. Details of each certification follow.

• CCN 141135 Federally qualified health center · Active · Name & address match · Details

Federally qualified health center certification: CCN 141135

Legal name

ACCESS GATEWAY CENTER FAMILY HEALTH CENTER

Certification status

Active

Provider type (POS)

Federally qualified health center

Participating since

Nov 24, 2010

Last certification

Nov 24, 2010

Ownership / control type

For profit – corporation

Facility address

526 Main Street
West Chicago, IL 60185

Related CCNs

141867

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

{
    "created_epoch": "1252454400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1296000000000",
    "number": "1184957151",
    "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": "526 MAIN ST",
            "city": "WEST CHICAGO",
            "state": "IL",
            "postal_code": "601852843",
            "telephone_number": "773-257-6770"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ACCESS COMMUNITY HEALTH NETWORK",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-09-09",
        "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": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• 4Pro Physical Therapy, LLC
• Access Community Health Network
• Access Immediate Care, LLC
• Jeniya Adams
• Adapt of Illinois, Inc.
• Qianna Diamond Adeyanju

• Federally Qualified Health Center (FQHC) in West Chicago, IL
• Providers in West Chicago, IL by specialty
• Federally Qualified Health Center (FQHC) in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 26, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.