| Chicago Family Health Center | |
|
9119 S. Exchange Ave. Chicago IL 60617 | |
| (773) 768-5000 | |
| (773) 374-1621 |
| Full Name | Chicago Family Health Center |
|---|---|
| Speciality | Clinic/Center |
| Location | 9119 S. Exchange Ave., Chicago, Illinois |
| Authorized Official Name and Position | Joseph Eric Boklage (CHIEF ADMINISTRATIVE OFFICER) |
| Authorized Official Contact | 7737685000 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Chicago Family Health Center 9119 S Exchange Ave Chicago IL 60617-4225 Ph: (773) 768-5000 | Chicago Family Health Center 9119 S. Exchange Ave. Chicago IL 60617 Ph: (773) 768-5000 |
| NPI Number | 1245266337 |
|---|---|
| Provider Enumeration Date | 06/23/2006 |
| Last Update Date | 09/21/2016 |
| Medicare PECOS PAC ID | 6608765417 |
|---|---|
| Medicare Enrollment ID | O20040311000364 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1245266337 | NPI | - | NPPES |
| 14D0696914 | Other | IL | CLIA LICENSE |
| 1168069 | Other | IL | CITY LICENSE |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |
| Provider Name | Ronald A Hickombottom |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1023020989 PECOS PAC ID: 8527020171 Enrollment ID: I20041027000542 |
| Provider Name | Angela J Griffin |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1770682775 PECOS PAC ID: 5799722989 Enrollment ID: I20050408001008 |
| Provider Name | Pramode Kumar Keshava |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1285670232 PECOS PAC ID: 1254372360 Enrollment ID: I20050519000235 |
| Provider Name | Susan T Oyetunde |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1699829747 PECOS PAC ID: 6406831445 Enrollment ID: I20050822001308 |
| Provider Name | Mary A Dean Onayemi |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1770518169 PECOS PAC ID: 7719900141 Enrollment ID: I20060111000569 |
| Provider Name | Tais V Crawford |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1376578799 PECOS PAC ID: 5698799468 Enrollment ID: I20060119000357 |
| Provider Name | Theisha Yvette Perkins |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1356459549 PECOS PAC ID: 2365459195 Enrollment ID: I20060320000188 |
| Provider Name | Lisa D. Daniel |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1982632865 PECOS PAC ID: 8729041306 Enrollment ID: I20061114000404 |
| Provider Name | Joyce M Smith |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1841307543 PECOS PAC ID: 6800995127 Enrollment ID: I20070626000822 |
| Provider Name | Asif N Daud |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1497872766 PECOS PAC ID: 3375612211 Enrollment ID: I20080519000760 |
| Provider Name | Carlos Sandoval-herrera |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1316244817 PECOS PAC ID: 5597937748 Enrollment ID: I20111011000723 |
| Provider Name | Jacqueline Y Gervais |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1699711648 PECOS PAC ID: 9931369279 Enrollment ID: I20120324000078 |
| Provider Name | Crystal A Peoples |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1588775696 PECOS PAC ID: 5991950040 Enrollment ID: I20130221000492 |
| Provider Name | Olutoyin M Okunfolami |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1326386558 PECOS PAC ID: 8325287816 Enrollment ID: I20130613000011 |
| Provider Name | Ramon Cabe |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1679518468 PECOS PAC ID: 5799094983 Enrollment ID: I20151029001699 |
| Provider Name | Melissa Duplantis |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1306153002 PECOS PAC ID: 7416267505 Enrollment ID: I20151102000707 |
| Provider Name | Christina Jaime |
|---|---|
| Provider Type | Practitioner - Oral Surgery |
| Provider Identifiers | NPI Number: 1154350791 PECOS PAC ID: 0244540375 Enrollment ID: I20151102002204 |
| Provider Name | Byron Thompson |
|---|---|
| Provider Type | Practitioner - Oral Surgery |
| Provider Identifiers | NPI Number: 1982729026 PECOS PAC ID: 1153631940 Enrollment ID: I20151106001042 |
| Provider Name | Erica Lauren Hirsh |
|---|---|
| Provider Type | Practitioner - Pediatric Medicine |
| Provider Identifiers | NPI Number: 1235495904 PECOS PAC ID: 6901048487 Enrollment ID: I20160128002470 |
| Provider Name | Tennille Nicole Jones |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1629422753 PECOS PAC ID: 8820397797 Enrollment ID: I20160427000887 |
| Provider Name | Brenda Y Jones |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1295196632 PECOS PAC ID: 8426347170 Enrollment ID: I20160519000050 |
| Provider Name | Kimberly Michelle Scott |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1164972055 PECOS PAC ID: 1850679150 Enrollment ID: I20161020000810 |
| Provider Name | Aaron Custer Brinkman |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1992951743 PECOS PAC ID: 9830364553 Enrollment ID: I20170508000010 |
| Provider Name | Stephanie Rzepka |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1184153637 PECOS PAC ID: 3173893757 Enrollment ID: I20170714002837 |
| Provider Name | Sonja Enge-gilton |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1659823458 PECOS PAC ID: 3375818065 Enrollment ID: I20171005001800 |
| Provider Name | Onna Ford-kendrick |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1578072815 PECOS PAC ID: 8022373109 Enrollment ID: I20180626000961 |
| Provider Name | Christina Lattner |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1174030811 PECOS PAC ID: 2264781012 Enrollment ID: I20180828001055 |
| Provider Name | Ophelia K. Carlton |
|---|---|
| Provider Type | Practitioner - Dentist |
| Provider Identifiers | NPI Number: 1720242852 PECOS PAC ID: 1658639224 Enrollment ID: I20180828001224 |
| Provider Name | Nancy Carter |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1417513813 PECOS PAC ID: 9638402027 Enrollment ID: I20190618002094 |
| Provider Name | Sommer Mckinney |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1578189577 PECOS PAC ID: 8921423393 Enrollment ID: I20200731002083 |
| Provider Name | Ernest Ogbeide |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1235763863 PECOS PAC ID: 1456776830 Enrollment ID: I20200731002148 |
| Provider Name | Galaxie Danielle Gavin |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1720572878 PECOS PAC ID: 9638596000 Enrollment ID: I20200831001404 |
| Provider Name | Vanesa Senteno |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1740831940 PECOS PAC ID: 8527479716 Enrollment ID: I20201118003266 |
| Provider Name | Phyllis Eggleston |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1043834435 PECOS PAC ID: 9133530009 Enrollment ID: I20201125000268 |
Pilsen Pediatrics Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1952 W Cermak Rd, Chicago, IL 60608 Phone: 773-254-6611 Fax: 773-254-8590 | |
A Kavaliunas Md Sc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 5540 S Pulaski Rd, Chicago, IL 60629 Phone: 773-585-2802 | |
Doc Cam Medical Center Sc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 2315 E 93rd St Ste 337, Chicago, IL 60617 Phone: 773-731-2700 Fax: 773-373-1868 | |
Excellent Eye Care Inc. Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 5352 N Milwaukee Ave, Chicago, IL 60630 Phone: 773-777-7444 Fax: 773-775-4030 | |
Pediatric General Care & Research Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 4527 N Pulaski Rd, Chicago, IL 60630 Phone: 773-267-7060 Fax: 773-267-4752 | |
Urban Family Health Center Inc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 10830 S Halsted St, Chicago, IL 60628 Phone: 773-264-1400 Fax: 773-264-1401 | |
Premier Primary Care And Alternative Medicine Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 1301 E 47th Street, Bldg 2 Suite B, Chicago, IL 60653 Phone: 773-891-2890 Fax: 773-891-4107 |