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NPI Code Detail

MEDICARE: FAMILY FIRST MEDICAL CARE, PLLC

MEDICARE: FAMILY FIRST MEDICAL CARE, PLLC
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
1207Q00000XFamily Medicine Physician

General Provider Information

NPI Number : 1861327496
Entity Type Code : Organization
Provider Name (Legal Business Name) : FAMILY FIRST MEDICAL CARE, PLLC
Provider Business Mailing Address
First Line : 833 OTTAWA AVE
Second Line :
City : PARK RIDGE
State : IL
Zip : 60068-2757
Country : US
Telephone Number : 847-962-3567
Fax Number :
Provider Business Practice Location Address
First Line : 6322 N CICERO AVE
Second Line :
City : CHICAGO
State : IL
Zip : 60646-4422
Country : US
Telephone Number : 847-962-3567
Fax Number :
Authorized Official
Title or Position : MEMBER OWNER
Name : DR. CHARMAINE M HENNES
Credential : MD
Telephone Number : 847-962-3567
Provider Enumeration Date : 06/15/2026
Last Update Date : 06/15/2026

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Directions to “FAMILY FIRST MEDICAL CARE, PLLC ” Practice Location

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