ERIE FAMILY HEALTH CENTER INC NPI 1770900839

NPI Information

NPI: 1770900839
Provider Name: ERIE FAMILY HEALTH CENTER INC

Doing Business As: ERIE HEALTH REACH MUNDELEIN HEALTH CENTER

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

Specialization: Federally Qualified Health Center (FQHC)

Address:
1701 W SUPERIOR ST
CHICAGO, IL
ZIP 60622
Phone: (312) 666-3494
Get Directions

ERIE FAMILY HEALTH CENTER INC is a federally qualified health center (fqhc) clinic center in Chicago, IL. ERIE FAMILY HEALTH CENTER INC NPI is 1770900839. The provider is registered as an organization entity type.
The provider Is Doing Business As Erie Health Reach Mundelein Health Center.

The provider's business location address is:

1701 W SUPERIOR ST
CHICAGO, IL
ZIP 60622-646
Phone: (312) 666-3494
Fax: (312) 666-0610

The provider's authorized official is Gabriela Norena .
The authorized official title is Billing Manager and has the following contact phone number (312) 432-7444.

The enumeration date for this NPI number is 3/26/2014 and was last updated on 3/26/2014.

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)		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

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

NPI Synchronization or Removal

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