Christian Community Health Center

Primary specialty

Community Health Clinic/CenterTaxonomy code 261QC1500X

Legal business name

CHRISTIAN COMMUNITY HEALTH CENTER

Practice address

1701 W Monterey Ave
Chicago, IL 60643-4257

Phone

(773) 233-5850

Fax

(773) 233-4055

NPI assigned

Sep 9, 2009

Organization subpart

No

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

Authorized official

Name

Virgil Tolbert

Title

Executive Director

Phone

(773) 233-4100

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Federally qualified health center certification: CCN 141127

Legal name

CHRISTIAN COMMUNITY HEALTH CENTER

Certification status

Active

Provider type (POS)

Federally qualified health center

Participating since

Sep 7, 2010

Last certification

Sep 7, 2010

Ownership / control type

For profit – corporation

Facility address

1701 W Monterey
Chicago, IL 60643

Related CCNs

141878

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

{
    "created_epoch": "1252454400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1644364800000",
    "number": "1396078374",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 288080",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606288080",
            "telephone_number": "773-233-4100",
            "fax_number": "773-233-4055"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1701 W MONTEREY AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606434257",
            "telephone_number": "773-233-5850",
            "fax_number": "773-233-4055"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHRISTIAN COMMUNITY HEALTH CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-09-09",
        "last_updated": "2022-02-09",
        "certification_date": "2022-02-09",
        "status": "A",
        "authorized_official_last_name": "TOLBERT",
        "authorized_official_first_name": "VIRGIL",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "773-233-4100"
    },
    "taxonomies": [
        {
            "code": "261QC1500X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Community Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mathias Aagaard Christensen, MD
• Thomas George Christensen
• Kendall Gina Christenson, RN
• Christi Lgardner
• Christian Community Health Center
• Christian Community Health Center
• Christian Community Health Center
• Christian Community Health Center
• Christian Community Health Center
• Carlton Everton Ivor Christian Jr., MD

• Community Health Clinic/Center in Chicago, IL
• Providers in Chicago, IL by specialty
• Community Health Clinic/Center in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 9, 2022; 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.