| Humboldt Park Health | |
|
1044 N Francisco Ave Chicago IL 60622 | |
| (773) 292-8200 | |
| (773) 278-3899 |
| Full Name | Humboldt Park Health |
|---|---|
| Speciality | Psychiatric Unit |
| Location | 1044 N Francisco Ave, Chicago, Illinois |
| Authorized Official Name and Position | Dorothy Cheryl Erins (CREDENTIALING SPECIALIST) |
| Authorized Official Contact | 2692445256 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Humboldt Park Health 1044 N Francisco Ave Chicago IL 60622-2743 Ph: (773) 292-8200 | Humboldt Park Health 1044 N Francisco Ave Chicago IL 60622 Ph: (773) 292-8200 |
| NPI Number | 1013944479 |
|---|---|
| Provider Enumeration Date | 06/28/2006 |
| Last Update Date | 01/27/2021 |
| Certification Date | 01/27/2021 |
| Medicare PECOS PAC ID | 8921907072 |
|---|---|
| Medicare Enrollment ID | O20080422000699 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1013944479 | NPI | - | NPPES |
| 14S206 | Other | IL | MEDICARE PROVIDER NUMBER |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 273R00000X | Psychiatric Unit | 0001727 (Illinois) | Primary |
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