Organization
ERIE FAMILY HEALTH CENTER, INC
Active
Organization
ERIE FAMILY HEALTH CENTER, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. LEE FRANCIS MD, MPH (PESIDENT AND CEO)
(312) 432-7394
Entity
Organization
Contact information
Practice address
1701 W SUPERIOR ST, CHICAGO, IL 60622-5646
(312) 432-7394
Mailing address
1701 W SUPERIOR ST, 3RD FLOOR, CHICAGO, IL 60622-5646
(312) 432-7394
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 PROVIDER NUMBER
IL
01
—
748480
MEDICARE PART B
IL
01
—
F100260003
MEDICARE PART B PTAN
WI
Enumeration date
08/02/2006
Last updated
11/02/2020
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