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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
1333600000XPharmacy
23336C0002XClinic Pharmacy
33336C0003XCommunity/Retail Pharmacy054013315IL

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
12023743OTHERPK

General Provider Information

NPI Number : 1679680235
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 : 3910 W OGDEN AVE
Second Line :
City : CHICAGO
State : IL
Zip : 60623-2470
Country : US
Telephone Number : 872-588-3256
Fax Number : 872-588-3251
Authorized Official
Title or Position : ASST DIR OF PATIENT ACCOUNTING
Name : KAREN JOHNSON
Credential :
Telephone Number : 872-588-3062
Provider Enumeration Date : 08/23/2006
Last Update Date : 07/01/2021

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Directions to “LAWNDALE CHRISTIAN HEALTH CENTER ” Practice Location

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