# STATE OF ILLINOIS

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- **Entity:** Organization
- **Status:** Active
- **Other names:** erie Family Health Center
- **Organization subpart:** No

## Provider details

- **NPI number:** 1609890235
- **Authorized official:** MR. CHRIS GREENWOOD (CASEMANAGER)
- **Authorized official phone:** (312) 666-3494

## Contact information

- **Practice address:** 2424W.CHARLESTON, CHICAGO, IL 60647
- **Practice address phone:** (773) 276-8863
- **Mailing address:** 2424W.CHARLESTON, CHICAGO, IL 60647
- **Mailing address phone:** (773) 276-8863

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 320700000X | Physical Disabilities Residential Treatment Facility | — | IL | Yes |

## Other

- **Enumeration date:** 07/27/2006
- **Last updated:** 08/22/2020