NPIMap

Organization Active NPI

Chicago Family Health Center

  • General Practice Physician
  • Chicago, IL
National Provider Identifier
1932301439
Registry record updated Apr 20, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
License
1769357 Issued in IL
Legal business name
CHICAGO FAMILY HEALTH CENTER
Practice address
2320 E 93Rd St
Floor 1
Chicago, IL 60617-3983
Phone
(773) 967-1135
Fax
(773) 374-1621
NPI assigned
Jun 5, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 20, 2008

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

Authorized official

Name
Mrs. Amelia Rodriguez
Title
Chief Financial Officer
Phone
(773) 768-5000

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208D00000X 1769357 IL Primary

Addresses

Primary practice location

2320 E 93Rd St
Floor 1
Chicago, IL 60617-3983

Mailing address

9119 S Exchange Ave
Chicago, IL 60617-4225
Phone (773) 768-5000

Other identifiers 2

IdentifierTypeStateIssuer
1769357OtherILCITY LICENSE
14D1059438OtherILCLIA LICENSE

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040311000364 IL Part B Supplier - Clinic/Group Practice 6608765417 Receives reassigned benefits from 40 practitioners
5 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Chicago, IL

Other NPIs on the same Medicare enrollment 5

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

National Provider Directory

National Provider Directory

Locations

2320 E 93rd St
Fl 1
Chicago, IL 60617
Phone (773) 967-1135

NPI Registry JSON

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

{
    "created_epoch": "1181001600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1208649600000",
    "number": "1932301439",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9119 S EXCHANGE AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606174225",
            "telephone_number": "773-768-5000",
            "fax_number": "773-374-1621"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2320 E 93RD ST",
            "address_2": "FLOOR 1",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606173983",
            "telephone_number": "773-967-1135",
            "fax_number": "773-374-1621"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHICAGO FAMILY HEALTH CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-06-05",
        "last_updated": "2008-04-20",
        "status": "A",
        "authorized_official_last_name": "RODRIGUEZ",
        "authorized_official_first_name": "AMELIA",
        "authorized_official_title_or_position": "CHIEF FINANCIAL OFFICER",
        "authorized_official_telephone_number": "773-768-5000",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "General Practice",
            "state": "IL",
            "license": "1769357",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CITY LICENSE",
            "identifier": "1769357",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CLIA LICENSE",
            "identifier": "14D1059438",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 20, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.