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Organization

ERIE FAMILY HEALTH CENTER INC

Active
Other names
Erie Foster Avenue Health Center
Organization subpart
No

Provider details

NPI number
Authorized official
MRS. GABRIELA NORENA (BILLING MANAGER)
(312) 432-7444
Entity
Organization

Contact information

Practice address
5215 N CALIFORNIA AVE STE F700, CHICAGO, IL 60625-7014
(312) 666-3494
(312) 666-0610
Mailing address
5215 N CALIFORNIA AVE STE F700, CHICAGO, IL 60625-7014
(312) 666-3494
(312) 666-0610

Taxonomy

Speciality
Code
Description
License number
State
261QF0400X
Federally Qualified Health Center (FQHC)
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1616827
BLUE CROSS BLUE SHIELD
IL
01
748480
MEDICARE PART B
IL
Enumeration date
05/14/2013
Last updated
05/14/2013
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