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NPI Code Detail

MEDICARE: LAWNDALE CHRISTIAN HEALTH CENTER

MEDICARE: LAWNDALE CHRISTIAN HEALTH CENTER
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
1261QF0400XFederally Qualified Health Center (FQHC)

General Provider Information

NPI Number : 1245289214
Entity Type Code : Organization
Provider Name (Legal Business Name) : LAWNDALE CHRISTIAN HEALTH CENTER
Provider Business Mailing Address
First Line : 3860 W OGDEN AVE
Second Line :
City : CHICAGO
State : IL
Zip : 60623-2460
Country : US
Telephone Number :
Fax Number : 773-843-2704
Provider Business Practice Location Address
First Line : 3860 W OGDEN AVE
Second Line :
City : CHICAGO
State : IL
Zip : 60623-2460
Country : US
Telephone Number : 773-843-2705
Fax Number : 773-843-2704
Authorized Official
Title or Position : ASST DIR OF PATIENT ACCOUNTING
Name : KAREN JOHNSON
Credential :
Telephone Number : 872-588-3062
Provider Enumeration Date : 05/08/2006
Last Update Date : 06/24/2021

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Directions to “LAWNDALE CHRISTIAN HEALTH CENTER ” Practice Location

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