Organization
FAMILY SERVICE AND MENTAL HEALTH CENTER OF CICERO
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LORENA NAVARRETE (OFFICE MANAGER)
(708) 656-6430
Entity
Organization
Contact information
Practice address
5341 W CERMAK RD, CICERO, IL 60804-2817
(708) 656-6430
(708) 656-6591
Mailing address
5341 W CERMAK RD, CICERO, IL 60804-2817
(708) 656-6430
(708) 656-6591
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
—
—
251S00000X
Community/Behavioral Health Agency
—
IL
251V00000X
Voluntary or Charitable Agency
—
—
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1098789
WELLCARE
IL
01
—
1179410
BEACON
IL
01
—
1617631
BLUE CROSS BLUE SHIELD
IL
01
—
5765456
AETNA
IL
01
—
B98842
HEALTH LINK
IL
01
—
QMP000002397118
MOLINA
IL
Enumeration date
07/21/2006
Last updated
08/14/2024
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