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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 : 1326215450
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 : 872-588-3000
Fax Number :
Provider Business Practice Location Address
First Line : 3517 W ARTHINGTON ST
Second Line :
City : CHICAGO
State : IL
Zip : 60624-4165
Country : US
Telephone Number : 872-588-3000
Fax Number : 872-588-3021
Authorized Official
Title or Position : ASST DIR OF PATIENT ACCOUNTING
Name : KAREN RENEE JOHNSON
Credential :
Telephone Number : 872-588-3062
Provider Enumeration Date : 05/08/2008
Last Update Date : 07/01/2021

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Directions to “LAWNDALE CHRISTIAN HEALTH CENTER ” Practice Location

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