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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)IL

General Provider Information

NPI Number : 1912944125
Entity Type Code : Organization
Provider Name (Legal Business Name) : ACCESS COMMUNITY HEALTH NETWORK
Provider Business Mailing Address
First Line : 222 N CANAL ST
Second Line :
City : CHICAGO
State : IL
Zip : 60606-1206
Country : US
Telephone Number : 312-526-2200
Fax Number :
Provider Business Practice Location Address
First Line : 3435 W VAN BUREN ST
Second Line :
City : CHICAGO
State : IL
Zip : 60624-3312
Country : US
Telephone Number : 773-265-0300
Fax Number :
Authorized Official
Title or Position : CEO
Name : DONNA THOMPSON
Credential :
Telephone Number : 312-526-2200
Provider Enumeration Date : 05/31/2006
Last Update Date : 07/21/2022

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Directions to “ACCESS COMMUNITY HEALTH NETWORK ” Practice Location

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