MEDICARE: CITY OF CHICAGO

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	261QC1500X	Community Health Clinic/Center		IL

General Provider Information

NPI Number	:	1992797138
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CITY OF CHICAGO

Provider Business Mailing Address
First Line	:	CHICAGO DEPARTMENT OF PUBLIC HEALTH
Second Line	:	111 W WASHINGTON ST, 4TH FL
City	:	CHICAGO
State	:	IL
Zip	:	60602
Country	:	US
Telephone Number	:	312-747-9443
Fax Number	:	312-747-9447

Provider Business Practice Location Address
First Line	:	ROSELAND M.H.C.
Second Line	:	200 E 115TH STREET
City	:	CHICAGO
State	:	IL
Zip	:	60628
Country	:	US
Telephone Number	:	312-747-1090
Fax Number	:	312-744-1904

Authorized Official
Title or Position	:	FIRST DEPUTY COMMISSIONER
Name	:	MATTHEW W. BEAUDET
Credential	:
Telephone Number	:	312-747-9889

Provider Enumeration Date	:	08/15/2005
Last Update Date	:	06/12/2025

Similar Medicare Providers

1780529677 — MR. SHERROD BROWN LCSW
Practice Location Address:

10536 S VERNON AVE
CHICAGO, IL
60628-2952

Practice Phone: 262-864-3804
Practice Fax:

1669079018 — ISMAIL ADEBAYO OYEBODE APN
Practice Location Address:

11000 S HALSTED ST
CHICAGO, IL
60628-3909

Practice Phone: 773-517-3183
Practice Fax:

1104657584 — MRS. KRYSTAL M FOWLER LCPC; LPC
Practice Location Address:

259 E 115TH ST
CHICAGO, IL
60628-5014

Practice Phone: 773-253-8385
Practice Fax:

1831664127 — DOLORITA HAKOMA ONGURU MSN, AGACNP-BC
Practice Location Address:

9500 S S. DORCHESTER , SUITE 100
CHICAGO, IL
60628

Practice Phone: 773-667-0768
Practice Fax: 773-667-5529

1508709148 — THE GOOD SAMARITAN HOUSE
Practice Location Address:

29 W 124TH ST FL 2
CHICAGO, IL
60628-7301

Practice Phone: 773-458-8539
Practice Fax:

1598757726 — CHICAGO DEPARTMENT OF PUBLIC HEALTH
Practice Location Address:

ROSELAND MENTAL HEALTH CENTER , 28 E 112TH PLACE
CHICAGO, IL
60628

Practice Phone: 312-747-7320
Practice Fax: 312-747-9143

Directions to “CITY OF CHICAGO ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.