| Santa Fe Family Health Center | |
|
720 Collins St Joliet IL 60432-1615 | |
| (815) 582-3565 | |
| (815) 582-3818 |
| Full Name | Santa Fe Family Health Center |
|---|---|
| Speciality | Family Medicine |
| Location | 720 Collins St, Joliet, Illinois |
| Authorized Official Name and Position | Abdulhamid Taha Hussein (OWNER) |
| Authorized Official Contact | 7089551793 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Santa Fe Family Health Center 720 Collins St Ste B Joliet IL 60432-1628 Ph: (708) 955-1793 | Santa Fe Family Health Center 720 Collins St Joliet IL 60432-1615 Ph: (815) 582-3565 |
| NPI Number | 1326224643 |
|---|---|
| Provider Enumeration Date | 01/16/2008 |
| Last Update Date | 08/03/2022 |
| Medicare PECOS PAC ID | 5193897270 |
|---|---|
| Medicare Enrollment ID | O20080707000386 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1326224643 | NPI | - | NPPES |
| 036-110260 | Other | IL | STATE LIC # |
| 036-107501 | Other | IL | STATE LIC # |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| Provider Name | Abdulhamid T Hussein |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1932158896 PECOS PAC ID: 3779572573 Enrollment ID: I20040507000647 |
| Provider Name | Ignacio J Orellana |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1003882259 PECOS PAC ID: 1456335892 Enrollment ID: I20040615000370 |
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