Healthcare Provider Details

I. General information

NPI: 1073208856
Provider Name (Legal Business Name): FAMILY HEALTHCARE CLINIC PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/07/2023
Last Update Date: 11/18/2025
Certification Date: 11/18/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

14500 JOHN HUMPHREY DR UNIT 6
ORLAND PARK IL
60462-2816
US

IV. Provider business mailing address

14500 JOHN HUMPHREY DR UNIT 6
ORLAND PARK IL
60462-2816
US

V. Phone/Fax

Practice location:
  • Phone: 312-489-6756
  • Fax: 773-595-3912
Mailing address:
  • Phone: 312-489-6756
  • Fax: 773-595-3912

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QP2300X
TaxonomyPrimary Care Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: KEVIN JOSEPH STROHL
Title or Position: AUTHORIZED OFFICIAL
Credential: FNP-BC
Phone: 312-489-6756