ERIE FAMILY HEALTH CENTER INC NPI 1629328836

NPI Information

NPI: 1629328836
Provider Name: ERIE FAMILY HEALTH CENTER INC

Doing Business As: ERIE EVANSTON HEALTH CENTER

Classification: Clinic/Center - 261QF0400X
Entity Type: Organization

Specialization: Federally Qualified Health Center (FQHC)

CLIA Number: 14D2045771

Address:
1285 HARTREY
EVANSTON, IL
ZIP 60202
Phone: (312) 666-3494
Get Directions

ERIE FAMILY HEALTH CENTER INC is a federally qualified health center (fqhc) clinic center in Evanston, IL. ERIE FAMILY HEALTH CENTER INC NPI is 1629328836. The provider is registered as an organization entity type.
The provider Is Doing Business As Erie Evanston Health Center.

The provider's business location address is:

1285 HARTREY
EVANSTON, IL
ZIP 60202-056
Phone: (312) 666-3494
Fax: (312) 666-0610

The provider's authorized official is Lee Francis .
The authorized official title is President And Ceo and has the following contact phone number (312) 432-7394.

The CLIA number assigned to this NPI record is 14D2045771 - federally qualified health center with a certificate type of Certificate for Provider-Performed Microscopy Procedures (PPMP).

The enumeration date for this NPI number is 9/14/2012 and was last updated on 11/25/2015.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	261QF0400X	Clinic/Center	Federally Qualified Health Center (FQHC)			No
2	261QF0400X	Clinic/Center	Federally Qualified Health Center (FQHC)		ILLINOIS	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	1616827	OTHER	ILLINOIS	B/C B/S
2	748480	OTHER	ILLINOIS	MEDICARE PART B
3	141174	MEDICARE OSCAR/CERTIFICATION	ILLINOIS

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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