NPIMap

Organization Active NPI

Esperanza Health Centers

Doing business as Esperanza Little Village

  • Federally Qualified Health Center (FQHC)
  • Chicago, IL
National Provider Identifier
1477812030
Registry record updated Aug 2, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
Legal business name
ESPERANZA HEALTH CENTERS
Doing business as
Esperanza Little Village
Practice address
3059 W 26TH St
Chicago, IL 60623-4131
Phone
(773) 932-2111
NPI assigned
May 16, 2012
Last updated
Aug 2, 2023By the provider in NPPES
Organization subpart
Yes
Parent organization
ESPERANZA HEALTH CENTERSAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Aug 2, 2023

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

Authorized official

Name
Zachary Spreitzer
Title
Director of Finance
Phone
(773) 482-1966

Specialties & licenses 1

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

Addresses

Primary practice location

3059 W 26TH St
Chicago, IL 60623-4131

Mailing address

2001 S California Ave
Suite 100
Chicago, IL 60608-2486
Phone (773) 584-6200

Other names 1

  • Esperanza Little Village Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20050204000750 IL Part B Supplier - Clinic/Group Practice 2961453105 Receives reassigned benefits from 125 practitioners
12 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Chicago, IL
O20120822000216 IL Part A Provider - Federally Qualified Health Center (FQHC) 2961453105 Practice locations: Chicago, IL

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1477812030. Details of each certification follow.

Federally qualified health center certification: CCN 141172

Legal name
ESPERANZA HEALTH CENTERS
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Nov 9, 2012
Last certification
Nov 9, 2012
Ownership / control type
Non-profit – church related
Organization structure
CorporationNon-profit
Incorporated
May 26, 2004 in IL
Enrollment address
3059 West 26TH St
Chicago, IL 60623-4131

Other NPIs with the same Medicare PAC ID 6

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

Other NPIs on the same Medicare enrollment 12

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
14D2042445Esperanza Health Centers3059 W 26TH St, Chicago, IL 60623Certificate of waiverSep 4, 2027

National Provider Directory

National Provider Directory
Tax ID family
Centro de Salud Esperanza9 organizations share this tax ID, including this one
Part of
Centro de Salud Esperanza

Other organizations with this tax ID 8

Organizations that report the same tax identification number in the National Provider Directory.

Locations

4700 S California Ave
Chicago, IL 60632
Phone (708) 713-0078

6550 S Richmond St
Chicago, IL 60629
Phone (773) 309-4445

Ownership & related parties

All disclosed owners & managing parties 21

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

NameRoleSinceShare
Jodi Portnoy Individual Corporate Director Jun 1, 2015
Elba Aranda-Suh Individual Corporate Director Sep 1, 2017
Destiny Ortega Individual Corporate Director Nov 1, 2021
Erica Martinez Individual Corporate Director Nov 1, 2021
Joel Rodarte Individual Corporate Director Oct 1, 2018
Alison Gia Mac Nicholoff Individual Corporate Director Sep 11, 2006
Andrew J Van Wieren Individual Corporate OfficerCmo Dec 1, 2017
Li Yu Tan Individual Corporate Director Apr 1, 2019
Michael Chico Individual Corporate DirectorChairperson Feb 1, 2018
Charles Wintersteen Individual Corporate Director Nov 1, 2016
Jaime Arteaga Individual Corporate Director Nov 1, 2019
Nyla Diab Individual Corporate DirectorSecretary Nov 1, 2015
David Berkey Individual Corporate Director Apr 1, 2019
Ryan Gadia Individual Corporate OfficerCfo Nov 1, 2018
Marisela Lawson Individual Corporate Director Apr 1, 2019
Luis Gutierrez Individual Corporate DirectorVice Chairperson Sep 1, 2016
Linda Simon-Price Individual Corporate OfficerInterim Cmo Dec 1, 2021
W-2 Managing EmployeeInterim Cmo Dec 1, 2021
Rafael Robles Individual Corporate Director Apr 1, 2021
Carmen Vergara Individual Corporate OfficerCoo Jun 1, 2018
Brian Fredericks Individual Corporate DirectorTreasurer Jun 1, 2017
Daniel C Fulwiler Individual Corporate DirectorCeo Jul 1, 2012
W-2 Managing EmployeeCeo Jul 1, 2012

Owners & managing parties with NPI records 2

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

Practitioners & affiliated clinicians

Practitioners 24

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.

View all 24

NPI Registry JSON

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

{
    "created_epoch": "1337126400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1690934400000",
    "number": "1477812030",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2001 S CALIFORNIA AVE",
            "address_2": "SUITE 100",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606082486",
            "telephone_number": "773-584-6200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3059 W 26TH ST",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606234131",
            "telephone_number": "773-932-2111"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ESPERANZA HEALTH CENTERS",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "ESPERANZA HEALTH CENTERS",
        "enumeration_date": "2012-05-16",
        "last_updated": "2023-08-02",
        "certification_date": "2023-08-02",
        "status": "A",
        "authorized_official_last_name": "SPREITZER",
        "authorized_official_first_name": "ZACHARY",
        "authorized_official_title_or_position": "DIRECTOR OF FINANCE",
        "authorized_official_telephone_number": "773-482-1966"
    },
    "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": "Esperanza Little Village",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Esperanza Little Village",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.