Evergreen Park Cu HS Dist 231

Primary specialty

Student Health Clinic/CenterTaxonomy code 261QS1000X

Legal business name

EVERGREEN PARK CU HS DIST 231

Practice address

9901 S Kedzie Ave
Evergreen Park, IL 60805-3416

Phone

(708) 424-7400

Fax

(708) 424-7497

NPI assigned

Apr 2, 2007

Organization subpart

No

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

Authorized official

Name

Norah Fahlen

Title

Director

Phone

(708) 424-7400

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1175472000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1700907425",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9901 S KEDZIE AVE",
            "city": "EVERGREEN PARK",
            "state": "IL",
            "postal_code": "608053416",
            "telephone_number": "708-424-7400",
            "fax_number": "708-424-7497"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9901 S KEDZIE AVE",
            "city": "EVERGREEN PARK",
            "state": "IL",
            "postal_code": "608053416",
            "telephone_number": "708-424-7400",
            "fax_number": "708-424-7497"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EVERGREEN PARK CU HS DIST 231",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-02",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "FAHLEN",
        "authorized_official_first_name": "NORAH",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "708-424-7400"
    },
    "taxonomies": [
        {
            "code": "261QS1000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Student Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Student Health Clinic/Center in Evergreen Park, IL
• Providers in Evergreen Park, IL by specialty
• Student Health Clinic/Center in Illinois

• 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.