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CIRCLE FAMILY CARE NPI 1124298492


NPI Information

NPI: 1124298492
Provider Name: CIRCLE FAMILY CARE
Classification: Clinic/Center - 261QF0400X
Entity Type: Organization

Specialization: Federally Qualified Health Center (FQHC)

Address:
4909 W DIVISION ST
SUITE 307
CHICAGO, IL
ZIP 60651
Phone: (773) 379-1000
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CIRCLE FAMILY CARE is a federally qualified health center (fqhc) clinic center in Chicago, IL. CIRCLE FAMILY CARE NPI is 1124298492. The provider is registered as an organization entity type.

The provider's business location address is:

4909 W DIVISION ST
SUITE 307
CHICAGO, IL
ZIP 60651-161
Phone: (773) 379-1000
Fax: (773) 379-1342

The provider's authorized official is Reuben Pettiford .
The authorized official title is President And Ceo and has the following contact phone number (773) 379-1000.

The enumeration date for this NPI number is 3/3/2008 and was last updated on 4/20/2008.


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 CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1261QF0400XClinic/CenterFederally Qualified Health Center (FQHC)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 IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
1=========011MEDICAIDILLINOIS

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: 11/14/2023

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.