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NPI Code Detail

MEDICARE: FRIEND FAMILY HEALTH CENTER INC

MEDICARE: FRIEND FAMILY HEALTH CENTER INC
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 : 1578560090
Entity Type Code : Organization
Provider Name (Legal Business Name) : FRIEND FAMILY HEALTH CENTER INC
Provider Business Mailing Address
First Line : 800 E 55TH ST
Second Line :
City : CHICAGO
State : IL
Zip : 60615-4906
Country : US
Telephone Number : 773-702-0660
Fax Number : 773-702-4356
Provider Business Practice Location Address
First Line : 6250 S COTTAGE GROVE AVE
Second Line :
City : CHICAGO
State : IL
Zip : 60637-2530
Country : US
Telephone Number : 773-702-0660
Fax Number : 773-702-4356
Authorized Official
Title or Position : CEO
Name : VERNEDA BACHUS
Credential :
Telephone Number : 773-702-2193
Provider Enumeration Date : 06/30/2005
Last Update Date : 09/11/2023

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Directions to “FRIEND FAMILY HEALTH CENTER INC ” Practice Location

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