Healthcare Provider Details

I. General information

NPI: 1962208470
Provider Name (Legal Business Name): FCHN PROGRAM INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/24/2025
Last Update Date: 02/24/2025
Certification Date: 02/24/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1234 W 59TH ST
CHICAGO IL
60636-1934
US

IV. Provider business mailing address

9929 S MORGAN ST
CHICAGO IL
60643-2218
US

V. Phone/Fax

Practice location:
  • Phone: 312-709-2056
  • Fax: 312-275-7368
Mailing address:
  • Phone: 312-709-2056
  • Fax: 312-275-7368

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code343900000X
TaxonomyNon-emergency Medical Transport (VAN)
License Number
License Number State

VIII. Authorized Official

Name: MS. SHEILA V PRICE
Title or Position: CEO
Credential:
Phone: 312-709-2056