NPIMap

Organization Active NPI

Greater Family Health

  • Federally Qualified Health Center (FQHC)
  • Franklin Park, IL
National Provider Identifier
1376294793
Registry record updated Jan 18, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
Legal business name
GREATER FAMILY HEALTH
Practice address
10225 Grand Ave
Franklin Park, IL 60131-3138
Phone
(844) 599-3700
Fax
(847) 841-6739
NPI assigned
Jan 18, 2022
Last updated
Jan 18, 2022By the provider in NPPES
Organization subpart
Yes
Parent organization
GREATER FAMILY HEALTHAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jan 18, 2022

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

Authorized official

Name
Marlen Hurtado
Title
Billing Lead
Phone
(847) 608-6318

Specialties & licenses 1

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

Addresses

Primary practice location

10225 Grand Ave
Franklin Park, IL 60131-3138

Mailing address

370 Summit St
Elgin, IL 60120-3843
Phone (844) 599-3700

Other names 1

  • Greater Elgin Family Care Center Former legal business name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20230310001206 IL Part A Provider - Federally Qualified Health Center (FQHC) 9931018769 Practice locations: Franklin Park, IL

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1376294793. Details of each certification follow.

Federally qualified health center certification: CCN 781199

Legal name
GREATER FAMILY HEALTH
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Jun 22, 2023
Last certification
Jun 22, 2023
Ownership / control type
For profit – corporation
Organization structure
CorporationNon-profit
Incorporated
Aug 28, 1998 in IL
Enrollment address
10225 Grand Ave
Franklin Park, IL 60131-3138

Other NPIs with the same Medicare PAC ID 10

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

National Provider Directory

National Provider Directory
Tax ID family
Greater Elgin Famly Care Cener85 organizations share this tax ID, including this one
Part of
Greater Elgin Famly Care Cener

Organizations with this tax ID in the same state 24

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 24

Ownership & related parties

All disclosed owners & managing parties 4

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

NameRoleSinceShare
Corey Dixon Individual Corporate Officer Feb 1, 2002
Paul Bednar Individual Corporate Officer Sep 1, 2002
Craig Dodt Individual Corporate Officer Sep 1, 2002
Jason Carey Individual Corporate OfficerChief Financial Officer Jan 26, 2009 100%
W-2 Managing EmployeeChief Financial Officer Jan 26, 2009 100%

NPI Registry JSON

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

{
    "created_epoch": "1642464000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1642464000000",
    "number": "1376294793",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "370 SUMMIT ST",
            "city": "ELGIN",
            "state": "IL",
            "postal_code": "601203843",
            "telephone_number": "844-599-3700",
            "fax_number": "847-841-6739"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10225 GRAND AVE",
            "city": "FRANKLIN PARK",
            "state": "IL",
            "postal_code": "601313138",
            "telephone_number": "844-599-3700",
            "fax_number": "847-841-6739"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GREATER FAMILY HEALTH",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "GREATER FAMILY HEALTH",
        "enumeration_date": "2022-01-18",
        "last_updated": "2022-01-18",
        "certification_date": "2022-01-18",
        "status": "A",
        "authorized_official_last_name": "HURTADO",
        "authorized_official_first_name": "MARLEN",
        "authorized_official_title_or_position": "BILLING LEAD",
        "authorized_official_telephone_number": "847-608-6318"
    },
    "taxonomies": [
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Greater Elgin Family Care Center",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

Other providers in Franklin Park, IL

Sources for this page

Verify at the official NPI Registry.