| Christian Community Health Center | |
|
9718 S Halsted Chicago IL 60628 | |
| (773) 233-4100 | |
| (773) 233-8542 |
| Full Name | Christian Community Health Center |
|---|---|
| Speciality | Clinic/Center |
| Location | 9718 S Halsted, Chicago, Illinois |
| Authorized Official Name and Position | Kenneth A. Burnett (CHIEF EXECUTIVE OFFICER) |
| Authorized Official Contact | 7732334100 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Christian Community Health Center Po Box 288080 9718 S Halsted Chicago IL 60628 Ph: (773) 233-4100 | Christian Community Health Center 9718 S Halsted Chicago IL 60628 Ph: (773) 233-4100 |
| NPI Number | 1790888238 |
|---|---|
| Provider Enumeration Date | 09/07/2006 |
| Last Update Date | 02/09/2022 |
| Medicare PECOS PAC ID | 4284533183 |
|---|---|
| Medicare Enrollment ID | O20040108000515 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1790888238 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |
| Provider Name | Olatunji R Akintilo |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1760485007 PECOS PAC ID: 9234043282 Enrollment ID: I20031114000289 |
| Provider Name | Victor L Thomas |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1619939212 PECOS PAC ID: 0345138335 Enrollment ID: I20040310000591 |
| Provider Name | Johnny White |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1306149497 PECOS PAC ID: 9830186360 Enrollment ID: I20040427001556 |
| Provider Name | Fouad Al-qawasmi |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1093709438 PECOS PAC ID: 2062449598 Enrollment ID: I20050726000774 |
| Provider Name | Angela L Walker |
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology |
| Provider Identifiers | NPI Number: 1609936442 PECOS PAC ID: 5597766030 Enrollment ID: I20070125000233 |
| Provider Name | Angel Leake |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1679729842 PECOS PAC ID: 8527249671 Enrollment ID: I20110222000788 |
| Provider Name | Leo W Lavender |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1609255819 PECOS PAC ID: 6002129350 Enrollment ID: I20150716000912 |
| Provider Name | Jennifer Yehkyung Seo |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1366707622 PECOS PAC ID: 6204069834 Enrollment ID: I20160506000445 |
| Provider Name | Brenda Y Jones |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1295196632 PECOS PAC ID: 8426347170 Enrollment ID: I20160519000050 |
| Provider Name | Leslie Dy-anne Moore |
|---|---|
| Provider Type | Practitioner - Certified Nurse Midwife (cnm) |
| Provider Identifiers | NPI Number: 1871961813 PECOS PAC ID: 6709145824 Enrollment ID: I20180118001829 |
| Provider Name | Patricia Grayson-canty |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1841768660 PECOS PAC ID: 9830434497 Enrollment ID: I20181231000732 |
| Provider Name | Martel S Warden |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1659837367 PECOS PAC ID: 1254661564 Enrollment ID: I20190930003232 |
| Provider Name | Dorothy Mato Akaeze |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1649641747 PECOS PAC ID: 4880920057 Enrollment ID: I20191002003497 |
| Provider Name | Jovan L Butler |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1235783267 PECOS PAC ID: 3870926157 Enrollment ID: I20191126002403 |
| Provider Name | Betty Coleman-bradley |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1255907283 PECOS PAC ID: 5193125631 Enrollment ID: I20210621001523 |
| Provider Name | Delaina Michelle Swiney |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1285374728 PECOS PAC ID: 9234516931 Enrollment ID: I20220518002800 |
| Provider Name | Idayatu Ola Omoniyi |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1174282826 PECOS PAC ID: 3476929860 Enrollment ID: I20221027000383 |
| Provider Name | Michelle Doriety |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1972209690 PECOS PAC ID: 2163883323 Enrollment ID: I20230803002912 |
| Provider Name | Linna Mukamusoni |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1023720133 PECOS PAC ID: 7719335181 Enrollment ID: I20231122002693 |
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 |