MEDICARE: FAMILY CHRISTIAN HEALTH CENTER

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
1	261QF0400X	Federally Qualified Health Center (FQHC)

General Provider Information

NPI Number	:	1336433382
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	FAMILY CHRISTIAN HEALTH CENTER

Provider Business Mailing Address
First Line	:	31 W 155TH ST
Second Line	:
City	:	HARVEY
State	:	IL
Zip	:	60426-3556
Country	:	US
Telephone Number	:	708-596-5177
Fax Number	:

Provider Business Practice Location Address
First Line	:	713 E 142ND ST
Second Line	:
City	:	DOLTON
State	:	IL
Zip	:	60419-1062
Country	:	US
Telephone Number	:	708-596-5177
Fax Number	:

Authorized Official
Title or Position	:	CEO
Name	:	DR. LISA J GREEN
Credential	:	D.O.
Telephone Number	:	708-339-5521

Provider Enumeration Date	:	06/07/2011
Last Update Date	:	07/16/2025

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