FAMILY CHRISTIAN HEALTH CENTER (NPI# 1336433382) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1336433382 |
| Entity Type | Organization |
| Organization Name | FAMILY CHRISTIAN HEALTH CENTER |
| Other Organization Name | FAMILY CHRISTIAN HEALTH CENTER-DOLTON |
| Practice Address |
713 E 142nd St Dolton IL 60419-1062 |
| Mailing Address |
31 W 155th St Harvey IL 60426-3556 |
| Practice Telephone | 7085965177 |
| Mailing Telephone | 7085965177 |
| Enumeration Date | 2011-06-07 |
| Last Update Date | 2020-06-30 |
| Authorized Official Name | DR. LISA J GREEN (CEO) |
| Authorized Official Telephone | 7083395521 |
| Authorized Official Credential | D.O. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QF0400X |
Clinic/Center Specialization: Federally Qualified Health Center (FQHC) |
Ambulatory Health Care Facilities |
| Other Name | Type Code |
|---|---|
| Family Christian Health Center-Dolton | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1952754582 | Family Christian Health Center | Clinic/Center | 19767 Torrence Ave, Lynwood, IL 60411-7624 | 2016-07-19 |
| 1750642856 | Family Christian Health Center | Clinic/Center | 31 W 155th St, Harvey, IL 60426-3556 | 2012-06-05 |
| 1093855736 | Family Christian Health Center | Dentist | 31 W 155th St, Harvey, IL 60426-3556 | 2007-02-08 |
| Street Address |
713 E 142ND ST |
| City | DOLTON |
| State | IL |
| Zip Code | 60419-1062 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1013916089 | Bohdan Askold Iwanetz | Surgery | 713 E 142nd St, Dolton, IL 60419-1062 | 2005-07-20 |
| 1356974786 | Susan Gwodz | Emergency Medicine | 713 E 142nd St, Dolton, IL 60419-1062 | 2020-02-13 |
| 1518072024 | Jaroslaus T Iwanetz Md Sc | Family Medicine | 713 E 142nd St, Dolton, IL 60419-1062 | 2006-08-21 |
| 1265451611 | Dev D Sharma | Surgery | 713 E 142nd St, Dolton, IL 60419-1062 | 2006-07-18 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1063985174 | Adesola O Bello | Occupational Therapist | 15325 Dante Ave, Dolton, IL 60419 | 2019-01-10 |
| 1780159657 | Angela Denice Carter | Social Worker | 15400 University, Dolton, IL 60419 | 2018-10-08 |
| 1417322165 | Gregory Peck Stapleton Sr. | Non-emergency Medical Transport (VAN) | 15320 South Evers, Dolton, IL 60419 | 2015-12-07 |
| 1780055624 | Royal Estates Assistive Living LLC | Assisted Living Facility | 1515 E 154th St., Dolton, IL 60419 | 2015-10-19 |
| 1013217264 | Bestmed-care Services,ltd | Home Health | 15008 S Woodlawn Avenue, Dolton, IL 60419 | 2010-10-21 |
| 1689905168 | Faith Connections Home Health and Professional Service Corporation | Home Health | 15335 Sunset Dr, Dolton, IL 60419 | 2010-01-22 |
| 1053555235 | Aunt Martha's Youth Service Center, Inc | Community Based Residential Treatment Facility, Mental Illness | 14449 Vanburen, Dolton, IL 60419 | 2009-05-01 |
| 1912163437 | Quality Dental, Inc | Dentist | 1121 E. Sibley Blvd, Dolton, IL 60419 | 2008-08-04 |
| 1013138171 | Valerie Denise Hicks-beal | Developmental Therapist | 14501 S. Dobson, Dolton, IL 60419 | 2007-05-02 |
| 1417178096 | Rhonda D Williams | Occupational Therapy Assistant | 15205 Diekman Court, Dolton, IL 60419 | 2007-05-01 |
| Find all providers in zip 60419 | ||||
| Taxonomy Code | 261QF0400X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Federally Qualified Health Center (FQHC) |
| Definition to come... |
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| 1871117937 | Primecare Community Health Inc | Clinic/Center | 1431 N Western Ave Ste 101, Chicago, IL 60622-7712 | 2020-06-04 |
| 1639791569 | Community Health Partnership of Illinois | Clinic/Center | 201 W Kenyon Rd Bldg D, Champaign, IL 61820-7892 | 2020-05-14 |
| 1407482219 | Access Community Health Network | Clinic/Center | 6020 W Diversey Ave Bldg West, Chicago, IL 60639-1108 | 2020-03-13 |
| 1235769704 | Greater Elgin Family Care Center | Clinic/Center | 451 N Mclean Blvd, Elgin, IL 60123-3239 | 2020-01-23 |
| 1710517537 | Greater Elgin Family Care Center Integrated Health Home | Clinic/Center | 1100 Shirley Ave, Streamwood, IL 60107-3068 | 2020-01-21 |
| 1215578109 | Board of Trustees of Southern Illinois University | Clinic/Center | 205 S 24th St Ste 100, Quincy, IL 62301-4446 | 2019-10-02 |
| 1437708674 | Board of Trustees of Southern Illinois University | Clinic/Center | 300 W Oak Street, Carbondale, IL 62901 | 2019-09-10 |
| 1427600345 | The Board of Trustees of The University of Illinois | Clinic/Center | 6835 S Normal Blvd, Chicago, IL 60621-2535 | 2019-07-11 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.