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NPI Code Detail

MEDICARE: CIRCLE FAMILY CARE

MEDICARE: CIRCLE FAMILY CARE
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
1251S00000XCommunity/Behavioral Health Agency

General Provider Information

NPI Number : 1174794440
Entity Type Code : Organization
Provider Name (Legal Business Name) : CIRCLE FAMILY CARE
Provider Business Mailing Address
First Line : 1629 N HAMLIN AVE
Second Line :
City : CHICAGO
State : IL
Zip : 60647-4607
Country : US
Telephone Number : 773-379-1000
Fax Number : 773-379-1342
Provider Business Practice Location Address
First Line : 5002 W MADISON ST
Second Line :
City : CHICAGO
State : IL
Zip : 60644-4127
Country : US
Telephone Number : 773-379-1000
Fax Number : 773-379-1342
Authorized Official
Title or Position : PRESIDENT & CEO
Name : MR. REUBEN PETTIFORD
Credential :
Telephone Number : 773-379-1000
Provider Enumeration Date : 03/14/2008
Last Update Date : 04/20/2008

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Directions to “CIRCLE FAMILY CARE ” Practice Location

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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.

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