NPIMap

Organization Active NPI

Howard Brown Health Center

Doing business as Howard Brown Health at TPAN

  • Federally Qualified Health Center (FQHC)
  • Chicago, IL
National Provider Identifier
1356876387
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
Doing business as
Howard Brown Health at TPAN
Practice address
5537 N Broadway St
Ste 101
Chicago, IL 60640-1405
Phone
(773) 388-1600
Fax
(773) 388-8936
NPI assigned
Apr 27, 2017
Last updated
Apr 10, 2025By the provider in NPPES
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
Billing Manager
Phone
(872) 269-3491

Specialties & licenses 1

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

Addresses

Primary practice location

5537 N Broadway St
Ste 101
Chicago, IL 60640-1405

Mailing address

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

Other names 1

  • Howard Brown Health at TPAN Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20040325000526 IL Part B Supplier - Clinic/Group Practice 1052203155 Receives reassigned benefits from 165 practitioners
7 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Chicago, IL
O20171005002439 IL Part A Provider - Federally Qualified Health Center (FQHC) 1052203155 Practice locations: Chicago, IL

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1356876387. Details of each certification follow.

Federally qualified health center certification: CCN 781888

Legal name
HOWARD BROWN HEALTH CENTER
Doing business as
HOWARD BROWN HEALTH AT TPAN
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Sep 12, 2017
Last certification
Sep 12, 2017
Ownership / control type
For profit – corporation
Organization structure
CorporationNon-profit
Incorporated
Jan 1, 1974 in IL
Enrollment address
5537 N Broadway St
North Corridor
Chicago, IL 60640-1405

Other NPIs with the same Medicare PAC ID 8

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Other NPIs on the same Medicare enrollment 7

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

National Provider Directory

National Provider Directory

Ownership & related parties

All disclosed owners & managing parties 23

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Magda Houlberg Individual Corporate OfficerHealth Center Operations& Coo Feb 10, 2022
W-2 Managing EmployeeCeo Oct 1, 2012
Emily E Byrne-Driver Individual Corporate DirectorExec Vice Chair Jul 1, 2014
Dwight M Alden Individual Corporate DirectorChairman of the Board Jul 1, 2011
Ryan Garrison Individual Corporate DirectorBoard Member Jul 1, 2016
Vanessa Ann Griggley-Owens Individual Corporate OfficerBoard Member Oct 18, 2013
David E Munar Individual Corporate OfficerAuthorize Official/Ceo Feb 10, 2022
Operational/Managerial ControlPresident/Ceo Apr 1, 2014 100%
Bethany M Pagels-Minor Individual Corporate DirectorDirector Jul 1, 2016
W Robert Schultz Individual Corporate DirectorBoard Member Jul 1, 2014
Fawna MJ Stockwell Individual Corporate DirectorDirector Jul 1, 2015
Rebecca E Rowland Individual Corporate DirectorVice Chair Jul 1, 2014
Jeffrey P Todd Individual Corporate DirectorVice Chair Mar 28, 2011
Kinley G Preston Individual Corporate DirectorBoard Member Jul 1, 2016
Ryan D Siemers Individual Corporate DirectorDirector Jun 1, 2010
Francis L Buttitta Individual Corporate DirectorDirector Jun 29, 2010
Garrett M Taliaferro Individual Corporate DirectorDirector Jul 1, 2015
Robert Fortney Individual Corporate OfficerBoard Member Aug 26, 2013
Nathaniel C Thomas Individual Corporate DirectorDirector Jul 1, 2015
Sharon M Roberson Individual Corporate DirectorBoard Member Jul 1, 2016
Oscar I Zambrano Individual Corporate DirectorBoard Member Jul 1, 2014
Miguel a Torres Individual Corporate DirectorDirector Jul 1, 2014
Mario Treto Individual Corporate DirectorDirector Jul 1, 2014
Mark L Hawkins Individual Corporate DirectorVice Chair/Treasurer Sep 1, 2012
Rogelio R Fierro Individual Corporate DirectorBoard Member Jul 1, 2014

Owners & managing parties with NPI records 1

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

Practitioners & affiliated clinicians

Practitioners 22

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 22

NPI Registry JSON

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

{
    "created_epoch": "1493251200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1744243200000",
    "number": "1356876387",
    "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": "5537 N BROADWAY ST",
            "address_2": "STE 101",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606401405",
            "telephone_number": "773-388-1600",
            "fax_number": "773-388-8936"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HOWARD BROWN HEALTH CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-04-27",
        "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": "BILLING MANAGER",
        "authorized_official_telephone_number": "872-269-3491"
    },
    "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": "Howard Brown Health at TPAN",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Howard Brown Health at TPAN",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.