Erie Family Health Center, Inc

Primary specialty

Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X

Legal business name

ERIE FAMILY HEALTH CENTER, INC

Practice address

1313 N Claremont Ave
Chicago, IL 60622-2910

Phone

(773) 534-4044

NPI assigned

Sep 28, 2007

Organization subpart

No

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

Authorized official

Name

Miss Gabriela Norena

Title

Billing Department Supervisor

Phone

(312) 432-7444

Specialties & licenses 1

Addresses

Other identifiers 2

Other names 1

• Jose De Diego School Based Hlth Doing business as

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

{
    "created_epoch": "1190937600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1212364800000",
    "number": "1861689366",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1701 W SUPERIOR ST",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606225646",
            "telephone_number": "312-666-3494"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1313 N CLAREMONT AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606222910",
            "telephone_number": "773-534-4044"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ERIE FAMILY HEALTH CENTER, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-09-28",
        "last_updated": "2008-06-02",
        "status": "A",
        "authorized_official_last_name": "NORENA",
        "authorized_official_first_name": "GABRIELA",
        "authorized_official_title_or_position": "BILLING DEPARTMENT SUPERVISOR",
        "authorized_official_telephone_number": "312-432-7444",
        "authorized_official_name_prefix": "Miss"
    },
    "taxonomies": [
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PART  B",
            "identifier": "748480",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD PROVIDER NUMBER",
            "identifier": "1616827",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Jose De Diego School Based Hlth",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Erie Family Health Center, Inc
• Erie Family Health Center, Inc
• Erie Family Health Center, Inc
• Erie Family Health Center, Inc
• Erie Family Health Center, Inc
• Erie Family Health Center, Inc
• Erie Family Health Center, Inc
• Jacqueline Young Eriguel, DMD
• Erik Lees Counseling PLLC
• Erika C. Fay, Ma., LMFT

• All providers in Chicago, IL
• Federally Qualified Health Center (FQHC) in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 2, 2008; 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.