MEDICARE: HUMBOLDT PARK HEALTH

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number State
1	282N00000X	General Acute Care Hospital
2	273R00000X	Psychiatric Hospital Unit	IL
3	343900000X	Non-emergency Medical Transport (VAN)
4	282N00000X	General Acute Care Hospital	IL

General Provider Information

NPI Number	:	1972594877
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HUMBOLDT PARK HEALTH

Provider Business Mailing Address
First Line	:	1044 N FRANCISCO AVE
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60622-2743
Country	:	US
Telephone Number	:	773-292-8200
Fax Number	:	773-278-3899

Provider Business Practice Location Address
First Line	:	1044 NORTH FRANCISCO
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60622
Country	:	US
Telephone Number	:	773-292-8200
Fax Number	:	773-278-3899

Authorized Official
Title or Position	:	CREDENTIALING SPECIALIST
Name	:	DOROTHY CHERYL ERINS
Credential	:
Telephone Number	:	269-244-5256

Provider Enumeration Date	:	10/31/2005
Last Update Date	:	02/03/2026

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Directions to “HUMBOLDT PARK HEALTH ” Practice Location

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