NPIMap

Organization Active NPI

Friend Family Health Center, Inc

  • Assisted Living Facility
  • Chicago, IL
National Provider Identifier
1740635663
Registry record updated May 30, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Assisted Living FacilityTaxonomy code 310400000X
Legal business name
FRIEND FAMILY HEALTH CENTER, INC
Practice address
6134 S Cottage Grove Ave
Chicago, IL 60637
Phone
(773) 702-0660
Fax
(773) 702-4356
NPI assigned
Apr 28, 2016
Last updated
May 30, 2018By the provider in NPPES
Organization subpart
Yes
Parent organization
FRIEND FAMILY HEALTH CENTER INCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on May 30, 2018

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

Authorized official

Name
Sabrina Moore
Title
Cfo
Phone
(773) 702-0660

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Assisted Living Facility 310400000X NU Primary

Addresses

Primary practice location

6134 S Cottage Grove Ave
Chicago, IL 60637

Mailing address

800 E 55TH St
Chicago, IL 60615-4906
Phone (773) 702-0660

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040805001242 IL Part B Supplier - Clinic/Group Practice 2062494552 Receives reassigned benefits from 129 practitioners
8 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Chicago, IL

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1740635663. Details of each certification follow.

  • CCN 781900 Federally qualified health center · Active · Name & address match · Details

Federally qualified health center certification: CCN 781900

Name & address match This certification has no NPI in the Medicare enrollment files. CMS publishes enrollment files for six facility types only, so it was connected to this NPI by matching the name and address CMS publishes for it.

Legal name
FRIEND FAMILY HEALTH CENTER INC
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Mar 28, 2018
Last certification
Mar 28, 2018
Ownership / control type
For profit – corporation
Facility address
6134 S Cottage Grove Ave
Chicago, IL 60637

Other NPIs on the same Medicare enrollment 8

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

National Provider Directory

National Provider Directory
Part of
Friend Family Health Center Inc

Locations

5843 S Western Ave
Chicago, IL 60636
Phone (773) 434-8600

Practitioners & affiliated clinicians

Practitioners 18

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 18

NPI Registry JSON

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

{
    "created_epoch": "1461801600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1527638400000",
    "number": "1740635663",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "800 E 55TH ST",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606154906",
            "telephone_number": "773-702-0660",
            "fax_number": "773-702-4356"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6134 S COTTAGE GROVE AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "60637",
            "telephone_number": "773-702-0660",
            "fax_number": "773-702-4356"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FRIEND FAMILY HEALTH CENTER, INC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "FRIEND FAMILY HEALTH CENTER INC",
        "enumeration_date": "2016-04-28",
        "last_updated": "2018-05-30",
        "status": "A",
        "authorized_official_last_name": "MOORE",
        "authorized_official_first_name": "SABRINA",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "773-702-0660"
    },
    "taxonomies": [
        {
            "code": "310400000X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.