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NPI Code Detail

MEDICARE: ACCESS COMMUNITY HEALTH NETWORK

MEDICARE: ACCESS COMMUNITY HEALTH NETWORK
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1261QF0400XFederally Qualified Health Center (FQHC)

General Provider Information

NPI Number : 1043398217
Entity Type Code : Organization
Provider Name (Legal Business Name) : ACCESS COMMUNITY HEALTH NETWORK
Provider Business Mailing Address
First Line : 600 W FULTON
Second Line : SUITE 200
City : CHICAGO
State : IL
Zip : 60661-1262
Country : US
Telephone Number : 312-526-2051
Fax Number :
Provider Business Practice Location Address
First Line : 5159 S ASHLAND AVE
Second Line :
City : CHICAGO
State : IL
Zip : 60609-4931
Country : US
Telephone Number : 773-434-9216
Fax Number : 773-434-2670
Authorized Official
Title or Position : CEO
Name : DONNA THOMPSON
Credential :
Telephone Number : 312-526-2051
Provider Enumeration Date : 11/02/2006
Last Update Date : 12/10/2018

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Directions to “ACCESS COMMUNITY HEALTH NETWORK ” Practice Location

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