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CHRISTIAN COMMUNITY HEALTH CENTER NPI 1912170457


NPI Information

NPI: 1912170457
Provider Name: CHRISTIAN COMMUNITY HEALTH CENTER

Former Legal Business Name: ROSELAND CHRISTIAN HEALTH MINISTRIES

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

Specialization: Federally Qualified Health Center (FQHC)

CLIA Number: 14D0868212

Address:
901 E SIBLEY BLVD
SOUTH HOLLAND, IL
ZIP 60473
Phone: (708) 596-4111
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CHRISTIAN COMMUNITY HEALTH CENTER is a federally qualified health center (fqhc) clinic center in South Holland, IL. CHRISTIAN COMMUNITY HEALTH CENTER NPI is 1912170457. The provider is registered as an organization entity type.
The provider Former Legal Business Name Is Roseland Christian Health Ministries.

The provider's business location address is:

901 E SIBLEY BLVD
SOUTH HOLLAND, IL
ZIP 60473-166
Phone: (708) 596-4111
Fax: (773) 233-4055

The provider's authorized official is Kenneth A. Burnett .
The authorized official title is Chief Executive Officer and has the following contact phone number (773) 233-4100.

The CLIA number assigned to this NPI record is 14D0868212 - federally qualified health center with a certificate type of Certificate for Provider-Performed Microscopy Procedures (PPMP).

The enumeration date for this NPI number is 4/4/2008 and was last updated on 9/19/2023.


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
1261QF0400XClinic/CenterFederally Qualified Health Center (FQHC)ILLINOISNo
2261QF0400XClinic/CenterFederally Qualified Health Center (FQHC)Yes

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: 5/5/2024

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