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NPI Code Detail

MEDICARE: COMMUNITYHEALTH

MEDICARE: COMMUNITYHEALTH
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
1261QC1500XCommunity Health Clinic/CenterIL

General Provider Information

NPI Number : 1295947430
Entity Type Code : Organization
Provider Name (Legal Business Name) : COMMUNITYHEALTH
Provider Business Mailing Address
First Line : 2611 W CHICAGO AVE
Second Line :
City : CHICAGO
State : IL
Zip : 60622-4519
Country : US
Telephone Number : 773-395-9901
Fax Number : 773-395-9902
Provider Business Practice Location Address
First Line : 2611 W CHICAGO AVE
Second Line :
City : CHICAGO
State : IL
Zip : 60622-4519
Country : US
Telephone Number : 773-395-9901
Fax Number : 773-395-9902
Authorized Official
Title or Position : DIRECTOR OF PHARMACY OPERATIONS
Name : TONY BONGIORNO
Credential : PHARMD
Telephone Number : 773-395-9901
Provider Enumeration Date : 05/03/2007
Last Update Date : 07/21/2022

Similar Medicare Providers

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Practice Location Address:
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Practice Fax:
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1831456680 — SUZANNE MARTHA FLOOD R.N, ANP
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Practice Fax:
1972929883 — DR. MARA MICHAUD PHARM.D.
Practice Location Address:
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60622-4519
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Practice Fax:
1316364433 — MS. RACHEL BENNETT RN
Practice Location Address:
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60622-4519
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1770901605 — MS. MAGDA SAEZ
Practice Location Address:
2611 W CHICAGO AVE
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60622-4519
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Directions to “COMMUNITYHEALTH ” Practice Location

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