NPIMap

Organization Active NPI

Community Health Partnership of Illinois

Doing business as Princeville Medical Center

  • Federally Qualified Health Center (FQHC)
  • Princeville, IL
National Provider Identifier
1336767540
Registry record updated Jul 14, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
Legal business name
COMMUNITY HEALTH PARTNERSHIP OF ILLINOIS
Doing business as
Princeville Medical Center
Practice address
223 E Main St
Princeville, IL 61559-9654
Phone
(312) 795-0000
NPI assigned
Jul 14, 2020
Last updated
Jul 14, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 14, 2020

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

Authorized official

Name
Eleace Sawyers
Title
Ceo
Phone
(312) 795-0000

Specialties & licenses 1

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

Addresses

Primary practice location

223 E Main St
Princeville, IL 61559-9654

Mailing address

205 W Randolph St Ste 2222
Chicago, IL 60606-1814
Phone (312) 795-0000

Other names 1

  • PRINCEVILLE MEDICAL CENTER Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20130723000458 IL Part B Supplier - Clinic/Group Practice 6901053511 Receives reassigned benefits from 39 practitioners
9 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Rantoul, IL; Princeville, IL; Mendota, IL; Harvard, IL; Champaign, IL; Aurora, IL; Kankakee, IL

Other NPIs on the same Medicare enrollment 9

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Tax ID family
Community Health Partnership of Illinois12 organizations share this tax ID, including this one

Other organizations with this tax ID 11

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

Locations

202 N Schuyler Ave
Ste 206
Kankakee, IL 60901
Phone (312) 795-0000

1009 Main St
Mendota, IL 61342
Phone (312) 795-0000

520 E Wabash Ave
Rantoul, IL 61866
Phone (217) 839-0832

13711 W Jackson St
Woodstock, IL 60098
Phone (312) 795-0000

Practitioners & affiliated clinicians

Practitioners 40

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 40

NPI Registry JSON

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

{
    "created_epoch": "1594684800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1594684800000",
    "number": "1336767540",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "205 W RANDOLPH ST STE 2222",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606061814",
            "telephone_number": "312-795-0000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "223 E MAIN ST",
            "city": "PRINCEVILLE",
            "state": "IL",
            "postal_code": "615599654",
            "telephone_number": "312-795-0000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COMMUNITY HEALTH PARTNERSHIP OF ILLINOIS",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-07-14",
        "last_updated": "2020-07-14",
        "certification_date": "2020-07-14",
        "status": "A",
        "authorized_official_last_name": "SAWYERS",
        "authorized_official_first_name": "ELEACE",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "312-795-0000"
    },
    "taxonomies": [
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "PRINCEVILLE MEDICAL CENTER",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Princeville, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 14, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.