NPIMap

Organization Active NPI

Family Health and Wellness Center Inc

  • Family Medicine Physician
  • Chicago, IL
National Provider Identifier
1407809437
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
FAMILY HEALTH AND WELLNESS CENTER INC
Practice address
3435 W Van Buren St
Chicago, IL 60624-3312
Phone
(773) 264-0200
NPI assigned
May 19, 2006
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Igoni I Dokubo, MDNPI 1083608350
Title
Ceo
Phone
(773) 265-0200

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207Q00000X IL Primary

Addresses

Primary practice location

3435 W Van Buren St
Chicago, IL 60624-3312

Mailing address

3435 W Van Buren St
Chicago, IL 60624-3312
Phone (773) 264-0200

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": "1147996800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1407809437",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3435 W VAN BUREN ST",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606243312",
            "telephone_number": "773-264-0200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3435 W VAN BUREN ST",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606243312",
            "telephone_number": "773-264-0200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FAMILY HEALTH AND WELLNESS CENTER INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-19",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "DOKUBO",
        "authorized_official_first_name": "IGONI",
        "authorized_official_middle_name": "I",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "773-265-0200",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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 Aug 22, 2020; 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.