MEDICARE: HEAL-THY PEOPLE FAMILY CARE CENTER LTD

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
1	261QP2300X	Primary Care Clinic/Center	036110716	IL

General Provider Information

NPI Number	:	1386830040
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HEAL-THY PEOPLE FAMILY CARE CENTER LTD

Provider Business Mailing Address
First Line	:	6030 COLGATE LN
Second Line	:
City	:	MATTESON
State	:	IL
Zip	:	60443-1995
Country	:	US
Telephone Number	:	708-720-5161
Fax Number	:	708-720-5162

Provider Business Practice Location Address
First Line	:	2813 W 147TH ST
Second Line	:
City	:	POSEN
State	:	IL
Zip	:	60469
Country	:	US
Telephone Number	:	708-396-9777
Fax Number	:	708-720-5162

Authorized Official
Title or Position	:	MEDICAL DIRECTOR
Name	:	DR. LAVERNE MONISE BARNES
Credential	:	DO, MPH
Telephone Number	:	773-551-3246

Provider Enumeration Date	:	09/17/2007
Last Update Date	:	08/26/2015

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