| Friend Family Health Center, Inc | |
|
5843 S. Western Avenue Chicago IL 60636 | |
| (773) 702-2193 | |
| (773) 702-4356 |
| Full Name | Friend Family Health Center, Inc |
|---|---|
| Speciality | Clinic/Center |
| Location | 5843 S. Western Avenue, Chicago, Illinois |
| Authorized Official Name and Position | Sabrina Modre (CFO) |
| Authorized Official Contact | 7737022193 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Friend Family Health Center, Inc 5843 S. Western Avenue Chicago IL 60636 Ph: (773) 702-2193 | Friend Family Health Center, Inc 5843 S. Western Avenue Chicago IL 60636 Ph: (773) 702-2193 |
| NPI Number | 1457330870 |
|---|---|
| Provider Enumeration Date | 01/13/2006 |
| Last Update Date | 10/01/2009 |
| Medicare PECOS PAC ID | 2062494552 |
|---|---|
| Medicare Enrollment ID | O20040625000215 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1457330870 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |
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