Healthcare Provider Details

I. General information

NPI: 1033214416
Provider Name (Legal Business Name): COMMUNITY FIRST HEALTHCARE OF ILLINOIS, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/13/2006
Last Update Date: 08/07/2026
Certification Date: 08/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5645 W ADDISON ST
CHICAGO IL
60634-4403
US

IV. Provider business mailing address

5645 W ADDISON ST
CHICAGO IL
60634-4403
US

V. Phone/Fax

Practice location:
  • Phone: 773-282-7000
  • Fax: 773-794-7695
Mailing address:
  • Phone: 773-282-7000
  • Fax: 773-794-7695

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code273R00000X
TaxonomyPsychiatric Hospital Unit
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code282N00000X
TaxonomyGeneral Acute Care Hospital
License Number1719
License Number State

VIII. Authorized Official

Name: FAISAL MASTER
Title or Position: COO
Credential:
Phone: 773-794-4674