| Erie Foster Avenue Health Center | |
|
5215 N California Ave Ste F700 Chicago IL 60625-7014 | |
| (312) 666-3494 | |
| (312) 666-0610 |
| Full Name | Erie Foster Avenue Health Center |
|---|---|
| Speciality | Clinic/Center |
| Location | 5215 N California Ave Ste F700, Chicago, Illinois |
| Authorized Official Name and Position | Gabriela Norena (BILLING MANAGER) |
| Authorized Official Contact | 3124327444 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Erie Foster Avenue Health Center 5215 N California Ave Ste F700 Chicago IL 60625-7014 Ph: (312) 666-3494 | Erie Foster Avenue Health Center 5215 N California Ave Ste F700 Chicago IL 60625-7014 Ph: (312) 666-3494 |
| NPI Number | 1396181590 |
|---|---|
| Provider Enumeration Date | 05/14/2013 |
| Last Update Date | 05/14/2013 |
| Medicare PECOS PAC ID | 9537050422 |
|---|---|
| Medicare Enrollment ID | O20130619000005 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1396181590 | NPI | - | NPPES |
| 1616827 | Other | IL | BLUE CROSS BLUE SHIELD |
| 748480 | Other | IL | MEDICARE PART B |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |
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