NPIMap

Organization Active NPI

Community Health Partnership of Illinois

  • Federally Qualified Health Center (FQHC)
  • Urbana, IL
National Provider Identifier
1396154076
Registry record updated Aug 7, 2014
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
Practice address
21 West Kenyon Road
Urbana, IL 61820-1163
Phone
(217) 893-3052
Fax
(217) 893-8600
NPI assigned
Aug 7, 2014
Last updated
Aug 7, 2014By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 7, 2014

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

Authorized official

Name
Nicolas Garcia
Title
Director of Finance
Phone
(312) 795-0000

Specialties & licenses 1

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

Addresses

Primary practice location

21 West Kenyon Road
Urbana, IL 61820-1163

Mailing address

205 W Randolph St
Suite 2222
Chicago, IL 60606-1867
Phone (312) 795-0000

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

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1396154076. Details of each certification follow.

  • CCN 781835 Federally qualified health center · Active · Name & address match · Details

Federally qualified health center certification: CCN 781835

Name & address match This certification has no NPI in the Medicare enrollment files. CMS publishes enrollment files for six facility types only, so it was connected to this NPI by matching the name and address CMS publishes for it.

Legal name
COMMUNITY HEALTH PARTNERSHIP OF ILLINOIS
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Aug 12, 2015
Last certification
Aug 12, 2015
Ownership / control type
For profit – corporation
Facility address
21 West Kenyon Road
Champaign, IL 61820

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

Practitioners & affiliated clinicians

Practitioners 3

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": "1407369600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1407369600000",
    "number": "1396154076",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "205 W RANDOLPH ST",
            "address_2": "SUITE 2222",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606061867",
            "telephone_number": "312-795-0000",
            "fax_number": "312-795-0002"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21 WEST KENYON ROAD",
            "city": "URBANA",
            "state": "IL",
            "postal_code": "618201163",
            "telephone_number": "217-893-3052",
            "fax_number": "217-893-8600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COMMUNITY HEALTH PARTNERSHIP OF ILLINOIS",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-08-07",
        "last_updated": "2014-08-07",
        "status": "A",
        "authorized_official_last_name": "GARCIA",
        "authorized_official_first_name": "NICOLAS",
        "authorized_official_title_or_position": "DIRECTOR OF FINANCE",
        "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": []
}

Other providers in Urbana, IL

Sources for this page

Verify at the official NPI Registry.