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General NPI Number Information
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NPI Number | 1396181590
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Entity Type | Organization
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Legal Business Name | ERIE FAMILY HEALTH CENTER INC
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Dates
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Enumeration Date | 05/14/2013
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Last Update Date | 05/14/2013
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Provider Practice Location Address
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Address Line | 5215 N CALIFORNIA AVE STE F700
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City | CHICAGO
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State | IL
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Zip | 60625-7014
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Country | US
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Telephone | 312-666-3494
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Fax | 312-666-0610
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Provider Business Mailing Address
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Address Line | 5215 N CALIFORNIA AVE STE F700
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City | CHICAGO
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State | IL
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Zip | 60625-7014
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Country | US
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Telephone | 312-666-3494
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Fax | 312-666-0610
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Authorized Official
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Title or Position | BILLING MANAGER
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Name | MRS. GABRIELA NORENA
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Credential |
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Telephone | 312-432-7444
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QF0400X
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Taxonomy Name | Federally Qualified Health Center (FQHC)
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License Number |
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License Number State |
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