Organization
ERIE FAMILY HEALTH CENTER INC
Active
Organization
ERIE FAMILY HEALTH CENTER INC
Active
Other names
Erie Waukegan 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
1701 W SUPERIOR ST, CHICAGO, IL 60622-5646
(312) 666-3494
(312) 666-0610
Mailing address
2323 GRAND AVE, 2323 GRAND AVENUE, WAUKEGAN, IL 60085-3312
(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 SHIELDS
IL
Enumeration date
12/16/2013
Last updated
12/16/2013
Update your record
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