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NPI Code Detail

MEDICARE: FAMILY SERVICE AND MENTAL HEALTH CENTER OF CICERO

MEDICARE: FAMILY SERVICE AND MENTAL HEALTH CENTER OF CICERO
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
1251E00000XHome Health Agency
2251S00000XCommunity/Behavioral Health AgencyIL
3251V00000XVoluntary or Charitable Agency
4261QM0801XMental Health Clinic/Center (Including Community Mental Health Center)

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
15765456OTHERILAETNA
21617631OTHERILBLUE CROSS BLUE SHIELD
31179410OTHERILBEACON
4B98842OTHERILHEALTH LINK
51098789OTHERILWELLCARE
6QMP000002397118OTHERILMOLINA

General Provider Information

NPI Number : 1831119767
Entity Type Code : Organization
Provider Name (Legal Business Name) : FAMILY SERVICE AND MENTAL HEALTH CENTER OF CICERO
Provider Business Mailing Address
First Line : 5341 W CERMAK RD
Second Line :
City : CICERO
State : IL
Zip : 60804-2817
Country : US
Telephone Number : 708-656-6430
Fax Number : 708-656-6591
Provider Business Practice Location Address
First Line : 5341 W CERMAK RD
Second Line :
City : CICERO
State : IL
Zip : 60804-2817
Country : US
Telephone Number : 708-656-6430
Fax Number : 708-656-6591
Authorized Official
Title or Position : OFFICE MANAGER
Name : LORENA NAVARRETE
Credential :
Telephone Number : 708-656-6430
Provider Enumeration Date : 07/21/2006
Last Update Date : 08/14/2024

Similar Medicare Providers

1578587077 — MRS. KATHERINE BARTHOLOMEW LCSW
Practice Location Address:
5341 W CERMAK RD
CICERO, IL
60804-2817
Practice Phone: 708-656-6430
Practice Fax:
1336254440 — JOHN PATRICK MORGAN L.C.P.C.
Practice Location Address:
5341 W CERMAK RD
CICERO, IL
60804-2817
Practice Phone: 708-656-6430
Practice Fax: 708-656-6591
1780795948 — MS. KATHLEEN LOUISE ALLEN LCPC
Practice Location Address:
5341 W CERMAK RD
CICERO, IL
60804-2817
Practice Phone: 708-656-6430
Practice Fax: 708-656-6591
1134246127 — MRS. JANETTE MARTINEZ-LOPEZ QMHP, MA
Practice Location Address:
5341 W CERMAK RD
CICERO, IL
60804-2817
Practice Phone: 773-656-6430
Practice Fax: 708-656-6591
1518088533 — MISS BARBARA CAROL SUCH PSY.D.
Practice Location Address:
5341 W CERMAK RD
CICERO, IL
60804-2817
Practice Phone: 708-656-6430
Practice Fax: 708-656-6591
1760609143 — JORGE CAMARENA B.S.
Practice Location Address:
5341 W CERMAK RD
CICERO, IL
60804-2817
Practice Phone: 708-656-6430
Practice Fax: 708-656-6591

Directions to “FAMILY SERVICE AND MENTAL HEALTH CENTER OF CICERO ” Practice Location

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