ERIE FAMILY HEALTH CENTER, INC (NPI# 1770770273) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1770770273 |
Entity Type | Organization |
Organization Name | ERIE FAMILY HEALTH CENTER, INC |
Other Organization Name | ERIE WESTSIDE FAMILY HEALTH |
Practice Address |
646 N Lawndale Ave Chicago IL 60624-1254 |
Mailing Address |
1701 W Superior St Chicago IL 60622-5646 |
Practice Telephone | 3124327423 |
Mailing Telephone | 3126663494 |
Enumeration Date | 2007-09-28 |
Last Update Date | 2008-12-15 |
Authorized Official Name | MISS GABRIELA NORENA (BILLING DEPARTMENT SUPERVISOR) |
Authorized Official Telephone | 3124327444 |
Is Organization Subpart | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 261QF0400X |
Clinic/Center Specialization: Federally Qualified Health Center (FQHC) |
Ambulatory Health Care Facilities |
State | Issuer | Identifier | Type Code |
---|---|---|---|
IL | BLUE CROSS BLUE SHIELD PROVIDER NUMBER | 1616827 | 01 |
IL | MEDICARE PART B | 748480 | 01 |
Other Name | Type Code |
---|---|
Erie Westside Family Health | Doing Business As Name - Organization |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1861689366 | Erie Family Health Center, Inc | Clinic/Center | 1313 N Claremont Ave, Chicago, IL 60622-2910 | 2007-09-28 |
1134316631 | Erie Family Health Center, Inc | Clinic/Center | 1945 W Wilson Ave Fl 5, Chicago, IL 60640-5255 | 2007-09-28 |
1821565060 | Erie Family Health Center, Inc | Case Management | 1701 W Superior St Fl 3, Chicago, IL 60622-5646 | 2018-10-25 |
1407043912 | Erie Family Health Center, Inc | Clinic/Center | 2750 W North Ave, Chicago, IL 60647-5247 | 2007-09-28 |
1952598468 | Erie Family Health Center, Inc | Clinic/Center | 4759 N Kedzie Ave, Chicago, IL 60625-4420 | 2007-09-28 |
1760499545 | Erie Family Health Center, Inc | Clinic/Center | 1701 W Superior St, Chicago, IL 60622-5646 | 2006-08-02 |
Entity Type | Entity Name | Entity Address |
---|---|---|
System for Award Management (SAM) Entities | ERIE FAMILY HEALTH CENTER, INC. | 1701 W Superior Ave, Chicago, IL 60622-5646 |
Street Address |
646 N LAWNDALE AVE |
City | CHICAGO |
State | IL |
Zip Code | 60624-1254 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1538356639 | Jacqueline Mcsparron | Physician Assistant | 646 N Lawndale Ave, Chicago, IL 60624-1254 | 2007-10-02 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1669071932 | Euginia Ivanova | Counselor | 3410 W. Roosevelt Rd, Chicago, IL 60624 | 2020-10-19 |
1629619572 | Denise R Bean | Technician | 3322 West Polk St, Chicago, IL 60624 | 2019-10-02 |
1033693742 | Ahmed Hussain Memon | Nurse Practitioner | 3800 West Madison, Chicago, IL 60624 | 2018-09-18 |
1487104006 | Jeffrey Blythe | Social Worker | 3605 W. Fillmore Street, Ucan, Chicago, IL 60624 | 2016-10-06 |
1366992216 | Brian Macwilliams | Social Worker | 3605 W. Fillmore St, Chicago, IL 60624 | 2016-10-04 |
1982151510 | Darryl Lamont Clayton | Counselor | 3605 W. Fillmore, Chicago, IL 60624 | 2016-09-01 |
1821487646 | Total Enrichment Services Inc. | Counselor | 3335 W Washington Blvd, Chicago, IL 60624 | 2015-01-16 |
1295038818 | Raad N Rashan M D S C | Internal Medicine | 3743 W Chicago Ave, Chicago, IL 60624 | 2010-12-21 |
1194044453 | Theresa Roberts | Speech-Language Pathologist | 3240 W. Franklin Blvd, Chicago, IL 60624 | 2010-05-26 |
1154570208 | Ht Outpatient Pharmacy | Pharmacy | 3435 W Vanburen St, Chicago, IL 60624 | 2008-09-13 |
Find all providers in zip 60624 |
Taxonomy Code | 261QF0400X |
Grouping | Ambulatory Health Care Facilities |
Classification | Clinic/Center |
Specialization | Federally Qualified Health Center (FQHC) |
Definition to come... |
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1932724390 | Friend Family Health Center, Inc | Clinic/Center | 7355 S Jeffery Blvd, Chicago, IL 60649-3121 | 2020-06-11 |
1871117937 | Primecare Community Health Inc | Clinic/Center | 1431 N Western Ave Ste 101, Chicago, IL 60622-7712 | 2020-06-04 |
1407482219 | Access Community Health Network | Clinic/Center | 6020 W Diversey Ave Bldg West, Chicago, IL 60639-1108 | 2020-03-13 |
1427600345 | The Board of Trustees of The University of Illinois | Clinic/Center | 6835 S Normal Blvd, Chicago, IL 60621-2535 | 2019-07-11 |
1114498540 | Pcc Community Wellness Center | Clinic/Center | 115 N Parkside Ave Fl 1, Chicago, IL 60644-3040 | 2018-12-11 |
1427523125 | Howard Brown Health Center | Clinic/Center | 3533 W North Ave Ste 1, Chicago, IL 60647-7573 | 2018-10-09 |
1336626936 | Heartland International Health Center | Clinic/Center | 1631 W Jonquil Ter, Chicago, IL 60626-1103 | 2018-07-26 |
1760975304 | Inner-city Muslim Action Network | Clinic/Center | 2744 W 63rd St Bldg 2, Chicago, IL 60629-2343 | 2018-06-08 |
1417473851 | Howard Brown Health Center | Clinic/Center | 2800 N Sheridan Rd Ste 211, Chicago, IL 60657-6161 | 2017-08-17 |
1487193181 | Mile Square Englewood/cook Satellite Health and Wellness Center | Clinic/Center | 8150 S Bishop St, Chicago, IL 60620-3854 | 2017-02-15 |
Find all providers in CHICAGO |
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Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.