NPIMap

Organization Active NPI

Greater Family Health

  • Federally Qualified Health Center (FQHC)
  • Hanover Park, IL
National Provider Identifier
1861885949
Registry record updated May 27, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
Legal business name
GREATER FAMILY HEALTH
Practice address
1515 E Lake St
Hanover Park, IL 60133-4869
Phone
(844) 599-3700
NPI assigned
Mar 12, 2015
Last updated
May 27, 2021By the provider in NPPES
Organization subpart
Yes
Parent organization
GREATER FAMILY HEALTHAs reported in NPPES

NPPES NPI Registry

Updated by the provider on May 27, 2021

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

Authorized official

Name
Jason Carey
Title
Cfo
Phone
(847) 608-6053

Specialties & licenses 1

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

Addresses

Primary practice location

1515 E Lake St
Hanover Park, IL 60133-4869

Mailing address

370 Summit St
Elgin, IL 60120-3843
Phone (844) 599-3700

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20180823000712 IL Part A Provider - Federally Qualified Health Center (FQHC) 9931018769 Practice locations: Hanover Park, IL

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1861885949. Details of each certification follow.

Federally qualified health center certification: CCN 781910

Legal name
GREATER FAMILY HEALTH
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Aug 23, 2018
Last certification
Aug 23, 2018
Ownership / control type
For profit – corporation
Organization structure
CorporationNon-profit
Incorporated
Aug 27, 1998 in IL
Enrollment address
1515 E Lake St
Ste 202
Hanover Park, IL 60133-7152

Other NPIs with the same Medicare PAC ID 10

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

National Provider Directory

National Provider Directory
Tax ID family
Greter Elgin Family Care Center85 organizations share this tax ID, including this one
Part of
Greter Elgin Family Care Center

Organizations with this tax ID in the same state 18

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 18

Locations

135 E Irving Park Rd
Streamwood, IL 60107
Phone (630) 313-5300

Ownership & related parties

All disclosed owners & managing parties 8

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

NameRoleSinceShare
Jose Lara Individual Corporate Director Nov 1, 2023
Deborah Everett Individual Corporate Director Nov 1, 2023
Corey Dixon Individual Corporate Director Apr 13, 2015
Paul Bednar Individual Corporate Director Aug 13, 2012
Jason Carey Individual Corporate OfficerCchief Financial Officer Jan 26, 2009 33%
W-2 Managing EmployeeChief Financial Officer Jan 26, 2009
Laura Espinoza Individual Corporate Director Nov 1, 2023
Lizette Leanos Individual Corporate Director Nov 1, 2023
Brian Heimberg Individual Corporate Director Nov 1, 2023

Practitioners & affiliated clinicians

Practitioners 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1426118400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1622073600000",
    "number": "1861885949",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "370 SUMMIT ST",
            "city": "ELGIN",
            "state": "IL",
            "postal_code": "601203843",
            "telephone_number": "844-599-3700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1515 E LAKE ST",
            "city": "HANOVER PARK",
            "state": "IL",
            "postal_code": "601334869",
            "telephone_number": "844-599-3700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GREATER FAMILY HEALTH",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "GREATER FAMILY HEALTH",
        "enumeration_date": "2015-03-12",
        "last_updated": "2021-05-27",
        "certification_date": "2021-05-27",
        "status": "A",
        "authorized_official_last_name": "CAREY",
        "authorized_official_first_name": "JASON",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "847-608-6053"
    },
    "taxonomies": [
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hanover Park, IL

Sources for this page

Verify at the official NPI Registry.