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NPI Code Detail

MEDICARE: AMERICAN INDIAN HEALTH SERVICE OF CHICAGO INC

MEDICARE: AMERICAN INDIAN HEALTH SERVICE OF CHICAGO INC
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
1174H00000XHealth Educator
2261QF0400XFederally Qualified Health Center (FQHC)

General Provider Information

NPI Number : 1720776321
Entity Type Code : Organization
Provider Name (Legal Business Name) : AMERICAN INDIAN HEALTH SERVICE OF CHICAGO INC
Provider Business Mailing Address
First Line : 4326 W MONTROSE AVE
Second Line :
City : CHICAGO
State : IL
Zip : 60641-2016
Country : US
Telephone Number : 773-883-9100
Fax Number : 773-883-0005
Provider Business Practice Location Address
First Line : 4326 W MONTROSE AVE
Second Line :
City : CHICAGO
State : IL
Zip : 60641-2016
Country : US
Telephone Number : 773-883-9100
Fax Number : 773-883-0005
Authorized Official
Title or Position : QAQI/RISK MANAGMENT
Name : SHARON HOLT
Credential :
Telephone Number : 773-883-9100
Provider Enumeration Date : 05/01/2023
Last Update Date : 12/18/2025

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Directions to “AMERICAN INDIAN HEALTH SERVICE OF CHICAGO INC ” Practice Location

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