NPIMap

Organization Active NPI

Esperanza Health Centers

  • Federally Qualified Health Center (FQHC)
  • Chicago, IL
National Provider Identifier
1487124707
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
Practice address
4700 S California Ave
Chicago, IL 60632
Phone
(773) 584-6200
NPI assigned
Nov 29, 2018
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

4700 S California Ave
Chicago, IL 60632

Mailing address

2001 S California Ave Ste 100
Chicago, IL 60608-2486
Phone (773) 640-5785

Other names 1

  • Esperanza Brighton Park Other name

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
O20190326000343 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 1487124707. Details of each certification follow.

Federally qualified health center certification: CCN 781920

Legal name
ESPERANZA HEALTH CENTERS
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Mar 26, 2019
Last certification
Mar 26, 2019
Ownership / control type
For profit – corporation
Organization structure
CorporationNon-profit
Incorporated
May 26, 2004 in IL
Enrollment address
4700 S California Ave
Chicago, IL 60632-2016

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
14D2164303Esperanza Health Centers4700 S California Ave, Chicago, IL 60632Certificate of waiverApr 1, 2027

National Provider Directory

National Provider Directory
Part of
Esperanza Health Centers

Ownership & related parties

All disclosed owners & managing parties 20

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

NameRoleSinceShare
Elizabeth Negrete Individual W-2 Managing EmployeeRegional Dir of Clinical SVCS Feb 4, 2019
Jodi Portnoy Individual Corporate DirectorBoard of Directors Jun 15, 2015
Elba Aranda-Suh Individual Corporate DirectorBoard of Directors Sep 15, 2017
Jessica L Boland Individual W-2 Managing EmployeeDirector of Behavioral Health Sep 9, 2013
Joel Rodarte Individual Corporate DirectorBoard of Directors Oct 15, 2018
Andrew J Van Wieren Individual W-2 Managing EmployeeCmo Aug 11, 2014
Li Yu Tan Individual Corporate Director Apr 1, 2019
Theodore Hufstader Individual W-2 Managing EmployeeDirector of Quality Jan 15, 2018
Michael Chico Individual Corporate DirectorBoard of Directors Feb 15, 2018
Charles Wintersteen Individual Corporate DirectorBoard of Directors Nov 15, 2016
Ricardo Cifuentes Individual W-2 Managing EmployeeVP of External Affairs Jun 8, 2016
Nyla Diab Individual Corporate DirectorBoard President Nov 15, 2015
David Berkey Individual Corporate Director Apr 1, 2019
Ryan Gadia Individual Corporate OfficerCfo Nov 1, 2018
W-2 Managing EmployeeCfo Nov 2, 2015
Marisela Lawson Individual Corporate Director Apr 1, 2019
Luis Gutierrez Individual Corporate DirectorBoard Secretary Sep 15, 2016
Carmen Vergara Individual W-2 Managing EmployeeCoo Sep 26, 2011
Jeffrey McInnes Individual W-2 Managing EmployeeDirector of Billing Dec 14, 2015
Brian Fredericks Individual Corporate DirectorBoard Treasurer Jun 15, 2017
Daniel C Fulwiler Individual Corporate OfficerPresident/Ceo Apr 21, 2008

Owners & managing parties with NPI records 1

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

Practitioners & affiliated clinicians

Practitioners 15

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 15

NPI Registry JSON

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

{
    "created_epoch": "1543449600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1690934400000",
    "number": "1487124707",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2001 S CALIFORNIA AVE STE 100",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606082486",
            "telephone_number": "773-640-5785"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4700 S CALIFORNIA AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "60632",
            "telephone_number": "773-584-6200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ESPERANZA HEALTH CENTERS",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "ESPERANZA HEALTH CENTERS",
        "enumeration_date": "2018-11-29",
        "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 Brighton Park",
            "code": "5",
            "type": "Other Name"
        },
        {
            "organization_name": "Esperanza Brighton Park",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.