Organization Active NPI

Friendly Family Medical Care, Inc.

  • Primary Care Clinic/Center
  • Frankfort, IL
National Provider Identifier
1356592828
Registry record updated Feb 10, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Clinic/CenterTaxonomy code 261QP2300X
License
036101122 Issued in IL
Legal business name
FRIENDLY FAMILY MEDICAL CARE, INC.
Practice address
10225 W Lincoln Hwy
Frankfort, IL 60423-1279
Phone
(815) 464-0081
Fax
(815) 464-0538
NPI assigned
Oct 2, 2008
Last updated
Feb 10, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 10, 2021

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

Authorized official

Name
Dr. Tisa Anne Morris-Christian, M.D.NPI 1497866065
Title
Owner
Phone
(815) 464-0081

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Care Clinic/Center 261QP2300X 036101122 IL Primary

Addresses

Primary practice location

10225 W Lincoln Hwy
Frankfort, IL 60423-1279

Mailing address

10225 W Lincoln Hwy
Frankfort, IL 60423-1279
Phone (815) 464-0081

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20090121000397 IL Part B Supplier - Clinic/Group Practice 7517021421 Receives reassigned benefits from 1 practitioner
Practice locations: Frankfort, IL

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
14D1091023Friendly Family Medical Care Inc10225 W Lincoln Hwy, Frankfort, IL 60423Certificate of waiverOct 22, 2026

National Provider Directory

National Provider Directory

Locations

10225 W Lincoln Hwy
Frankfort, IL 60423
Phone (815) 464-0081

640 Bankview Dr
Frankfort, IL 60423

640 Bankview Dr
Ste 2
Frankfort, IL 60423
Phone (815) 412-0142

Practitioners & affiliated clinicians

Practitioners 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1222905600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1612915200000",
    "number": "1356592828",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10225 W LINCOLN HWY",
            "city": "FRANKFORT",
            "state": "IL",
            "postal_code": "604231279",
            "telephone_number": "815-464-0081",
            "fax_number": "815-464-0538"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10225 W LINCOLN HWY",
            "city": "FRANKFORT",
            "state": "IL",
            "postal_code": "604231279",
            "telephone_number": "815-464-0081",
            "fax_number": "815-464-0538"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FRIENDLY FAMILY MEDICAL CARE, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-10-02",
        "last_updated": "2021-02-10",
        "certification_date": "2021-02-10",
        "status": "A",
        "authorized_official_last_name": "MORRIS-CHRISTIAN",
        "authorized_official_first_name": "TISA",
        "authorized_official_middle_name": "ANNE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "815-464-0081",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": "IL",
            "license": "036101122",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Frankfort, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 10, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.