# CHRISTIAN COMMUNITY HEALTH CENTER

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1396078374
- **Authorized official:** VIRGIL TOLBERT (EXECUTIVE DIRECTOR)
- **Authorized official phone:** (773) 233-4100

## Contact information

- **Practice address:** 1701 W MONTEREY AVE, CHICAGO, IL 60643-4257
- **Practice address phone:** (773) 233-5850
- **Practice address fax:** (773) 233-4055
- **Mailing address:** PO BOX 288080, CHICAGO, IL 60628-8080
- **Mailing address phone:** (773) 233-4100
- **Mailing address fax:** (773) 233-4055

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QC1500X | Community Health Clinic/Center | — | NULL | Yes |

## Other

- **Enumeration date:** 09/09/2009
- **Last updated:** 02/09/2022