NPIMap

Organization Active NPI

Heartland International Health Center

  • Federally Qualified Health Center (FQHC)
  • Chicago, IL
National Provider Identifier
1407183734
Registry record updated Nov 6, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
Legal business name
HEARTLAND INTERNATIONAL HEALTH CENTER
Practice address
4740 N Clark St
Chicago, IL 60640-4689
Phone
(773) 751-1700
NPI assigned
Nov 6, 2009
Last updated
Nov 6, 2009By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 6, 2009

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

Authorized official

Name
Dr. Bechara Choucair, M.D.
Title
Executive/Medical Director
Phone
(773) 751-1700

Specialties & licenses 1

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

Addresses

Primary practice location

4740 N Clark St
Chicago, IL 60640-4689

Mailing address

4750 N Sheridan Rd
#434
Chicago, IL 60640-7528
Phone (773) 751-1700

Other names 1

  • Heartland Health Center-Clark Other name

National Provider Directory

National Provider Directory

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": "1257465600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1257465600000",
    "number": "1407183734",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4750 N SHERIDAN RD",
            "address_2": "#434",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606407528",
            "telephone_number": "773-751-1700",
            "fax_number": "773-275-3689"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4740 N CLARK ST",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606404689",
            "telephone_number": "773-751-1700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HEARTLAND INTERNATIONAL HEALTH CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-11-06",
        "last_updated": "2009-11-06",
        "status": "A",
        "authorized_official_last_name": "CHOUCAIR",
        "authorized_official_first_name": "BECHARA",
        "authorized_official_title_or_position": "EXECUTIVE/MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "773-751-1700",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "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": "Heartland Health Center-Clark",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Chicago, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 6, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.