Community Health Partnership of Illinois

Primary specialty

Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X

Legal business name

COMMUNITY HEALTH PARTNERSHIP OF ILLINOIS

Practice address

13711 W Jackson St
Woodstock, IL 60098-3141

Phone

(815) 337-9640

Fax

(815) 337-9641

NPI assigned

May 6, 2008

Organization subpart

No

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

Authorized official

Name

Susan Bauer, MA, MPH

Title

Executive Director

Phone

(312) 795-0000

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Federally qualified health center certification: CCN 141196

Legal name

COMMUNITY HEALTH PARTNERSHIP OF ILLINOIS

Certification status

Active

Provider type (POS)

Federally qualified health center

Participating since

May 6, 2013

Last certification

May 6, 2013

Ownership / control type

For profit – corporation

Facility address

13711 W Jackson St
Woodstock, IL 60098

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

• Community Health Partnership of Illinois

  • Federally Qualified Health Center (FQHC)
  • Rantoul, IL
  • NPI 1629383443

  Member Of

  NPD member

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Elizabeth Rios, APN

  • Family Nurse Practitioner
  • Woodstock, IL
  • NPI 1437417623
  NPD (past)

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

{
    "created_epoch": "1210032000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1366243200000",
    "number": "1194991455",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "205 W RANDOLPH ST",
            "address_2": "SUITE 2222",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606061867",
            "telephone_number": "312-795-0000",
            "fax_number": "312-795-0002"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13711 W JACKSON ST",
            "city": "WOODSTOCK",
            "state": "IL",
            "postal_code": "600983141",
            "telephone_number": "815-337-9640",
            "fax_number": "815-337-9641"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COMMUNITY HEALTH PARTNERSHIP OF ILLINOIS",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-05-06",
        "last_updated": "2013-04-18",
        "status": "A",
        "authorized_official_last_name": "BAUER",
        "authorized_official_first_name": "SUSAN",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "312-795-0000",
        "authorized_official_credential": "MA, MPH"
    },
    "taxonomies": [
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sarah Elizabeth Clark, LPC
• Phetsavanh Coggin, LCPC
• Community Chiropractic Center Woodstock SC
• Community Clinic Center, LTD
• Community Counseling Center, LTD.
• Timothy D Conway, DDS
• Richard O Cook, MD
• Evone Kay Coombs, MA, LCPC
• Kathleen Ann Cooper, MS, CCC-SLP
• Cornerstone Care Inc.

• Federally Qualified Health Center (FQHC) in Woodstock, IL
• Providers in Woodstock, 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 Apr 18, 2013; 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.