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Organization

ERIE FAMILY HEALTH CENTER INC

Active
Other names
Erie Division Street Health Center
Organization subpart
No

Provider details

NPI number
Authorized official
MISS GABRIELA NORENA (PATIENT ACCOUNT SUPERVISOR)
(312) 432-7444
Entity
Organization

Contact information

Practice address
2418 W DIVISION ST, CHICAGO, IL 60622-2940
(312) 666-3494
(312) 666-0610
Mailing address
1701 W SUPERIOR, CHICAGO, IL 60622-5646
(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
IL
Enumeration date
05/02/2012
Last updated
05/02/2012
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