COMMUNITY FIRST HEALTHCARE OF ILLINOIS, INC (NPI# 1942305321) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1942305321 |
| Entity Type | Organization |
| Organization Name | COMMUNITY FIRST HEALTHCARE OF ILLINOIS, INC |
| Other Organization Name | COMMUNITY FIRST MEDICAL CENTER |
| Practice Address |
5645 W Addison St Chicago IL 60634-4403 |
| Mailing Address |
5645 West Addison Chicago IL 60634 |
| Practice Telephone | 7732827000 |
| Mailing Telephone | 7732827000 |
| Enumeration Date | 2006-09-13 |
| Last Update Date | 2015-02-18 |
| Authorized Official Name | JIM SYKES (INTERIM CFO) |
| Authorized Official Telephone | 7737948320 |
| Is Organization Subpart | Y |
| Parent Organization Name | COMMUNITY FIRST MEDICAL CENTER |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 314000000X | Skilled Nursing Facility | 0001719 | Nursing & Custodial Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IL | BLUE CROSS OF IL SNF | 0911 | 01 |
| Other Name | Type Code |
|---|---|
| COMMUNITY FIRST MEDICAL CENTER | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1033214416 | Community First Healthcare of Illinois, Inc | General Acute Care Hospital | 5645 W Addison St, Chicago, IL 60634-4403 | 2006-09-13 |
| Street Address |
5645 W ADDISON ST |
| City | CHICAGO |
| State | IL |
| Zip Code | 60634-4403 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1306845763 | Our Lady of The Resurrection Medical Center | Emergency Medicine | 5645 W Addison St, Chicago, IL 60634-4403 | 2005-07-19 |
| 1740809797 | Nicholas Donald Charmelo | Registered Nurse | 5645 W Addison St, Chicago, IL 60634-2881 | 2020-04-09 |
| 1528695814 | Ana Bulaja | Physician Assistant | 5645 W Addison St, Chicago, IL 60634-2881 | 2020-03-25 |
| 1669008702 | Jeremy Blauser | Physician Assistant | 5645 W Addison St, Chicago, IL 60634-4403 | 2020-03-20 |
| 1598306870 | Sss Pathology Services Pllc | Pathology | 5645 W Addison St, Chicago, IL 60634-4403 | 2019-10-08 |
| 1639737851 | Akhter U Patel | Nurse Practitioner | 5645 W Addison St, Chicago, IL 60634-4403 | 2019-06-03 |
| 1457916124 | Jaclyn Novak | Physician Assistant | 5645 W Addison St, Chicago, IL 60634-4403 | 2019-05-07 |
| 1962977421 | Ashley Fisher | Dietitian, Registered | 5645 W Addison St, Chicago, IL 60634-4403 | 2018-10-10 |
| 1093211153 | Brandee Joy Grenda | Dietitian, Registered | 5645 W Addison St, Chicago, IL 60634-4403 | 2018-04-05 |
| 1639687825 | Amy M Boettcher | Nurse Anesthetist, Certified Registered | 5645 W Addison St, Chicago, IL 60634-4403 | 2018-01-22 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1356987333 | Alejandra Carrera | Student in an Organized Health Care Education/Training Program | 6417 W Irving Park Rd., Chicago, IL 60634 | 2019-11-25 |
| 1861977456 | Virtue Counseling Center | Counselor | 2904 N Parkside, Chicago, IL 60634 | 2018-09-28 |
| 1770931255 | Dynamic Transport Solutions LLC | Non-emergency Medical Transport (VAN) | 6109 W. Barry, Chicago, IL 60634 | 2016-05-25 |
| 1104284710 | Ez Dental | Dental Laboratory | 5621 W.montrose Avenue, Chicago, IL 60634 | 2016-02-10 |
| 1285075432 | Chicago Medical Transportation | Non-emergency Medical Transport (VAN) | 3033 N. Nordica Ave., Chicago, IL 60634 | 2013-07-16 |
| 1083985725 | Maria C. Rodriguez | Lactation Consultant, Non-RN | 6216 W. School St., Chicago, IL 60634 | 2012-01-25 |
| 1295066827 | Angie Harris | Occupational Therapist | 3339 N. Octavia, Chicago, IL 60634 | 2010-01-21 |
| 1205169802 | Belmont Dental P.C. | Dentist | 5611 W. Belmont Ave., Chicago, IL 60634 | 2009-09-14 |
| 1568605178 | Henry Biskup | Radiologic Technologist | 3105 N. Austin Ave., Chicago, IL 60634 | 2009-04-13 |
| 1306086624 | Highland Park Cvs, L.L.C. | Durable Medical Equipment & Medical Supplies | 3615 N. Central Ave, Chicago, IL 60634 | 2009-02-26 |
| Find all providers in zip 60634 | ||||
| Taxonomy Code | 314000000X |
| Grouping | Nursing & Custodial Care Facilities |
| Classification | Skilled Nursing Facility |
| (1) A skilled nursing facility is a facility or distinct part of an institution whose primary function is to provide medical, continuous nursing, and other health and social services to patients who are not in an acute phase of illness requiring services in a hospital, but who require primary restorative or skilled nursing services on an inpatient basis above the level of intermediate or custodial care in order to reach a degree of body functioning to permit self care in essential daily living. It meets any licensing or certification standards et forth by the jurisdiction where it is located. A skilled nursing facility may be a freestanding facility or part of a hospital that has been certified by Medicare to admit patients requiring subacute care and rehabilitation; (2) Provides non-acute medical and skilled nursing care services, therapy and social services under the supervision of a licensed registered nurse on a 24-hour basis. |
| Notes: Source: (1) "Glossary of terms used in managed care" Developed by the Managed Care Assembly (MCA) of Medical Group Management Association (MGMA), MGM Journal, September/October 1995, p. 64; (2) AHA Guide, 1996 Annual Survey. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1053812974 | Alden Estates-courts of Huntley, Inc. | Skilled Nursing Facility | 4200 W Peterson Ave Ste 140, Chicago, IL 60646-6819 | 2018-02-26 |
| 1194271825 | Veronica Mack | Skilled Nursing Facility | 9738 S Merrion Ave, Chicago, IL 60617-4846 | 2016-09-01 |
| 1982050886 | Bernadette Aguilar | Skilled Nursing Facility | 125 S Green St, Unit 808a, Chicago, IL 60607-3197 | 2016-05-10 |
| 1720445539 | Maria Callahan | Skilled Nursing Facility | 1839 S Prairie Pkwy, Chicago, IL 60616-4389 | 2016-01-25 |
| 1265856710 | Royal Staff Inc | Skilled Nursing Facility | 10934 S Beverly Ave, Chicago, IL 60643-3752 | 2014-02-04 |
| 1114355336 | Mobile Anesthesiologist | Skilled Nursing Facility | 8420 Bryn Mawr, Chicago, IL 60631 | 2013-10-25 |
| 1821439738 | Mercy Circle | Skilled Nursing Facility | 3659 W. 99th Street, Chicago, IL 60655 | 2013-07-09 |
| 1982946604 | Admiral At The Lake | Skilled Nursing Facility | 933 W. Foster Ave, Chicago, IL 60640 | 2013-03-20 |
| 1730447566 | Sound Imaging Inc. | Skilled Nursing Facility | 6970 N Mcalpin Ave, Chicago, IL 60646-1141 | 2012-04-30 |
| 1821355561 | Ltc Practitioners of Illinois | Skilled Nursing Facility | 3915 N. Kenneth Ave., Chicago, IL 60641-2816 | 2012-04-19 |
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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.