| South Family Health Center | |
|
6201 Roosevelt Rd Berwyn IL 60402-1108 | |
| (708) 386-0845 | |
| (708) 386-8472 |
| Full Name | South Family Health Center |
|---|---|
| Speciality | Clinic/Center |
| Location | 6201 Roosevelt Rd, Berwyn, Illinois |
| Authorized Official Name and Position | Robert J Urso (PRESIDENT & CEO) |
| Authorized Official Contact | 7083839786 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| South Family Health Center 6201 Roosevelt Rd Berwyn IL 60402-1108 Ph: (708) 386-0845 | South Family Health Center 6201 Roosevelt Rd Berwyn IL 60402-1108 Ph: (708) 386-0845 |
| NPI Number | 1174549786 |
|---|---|
| Provider Enumeration Date | 07/15/2006 |
| Last Update Date | 07/21/2022 |
| Medicare PECOS PAC ID | 1557270139 |
|---|---|
| Medicare Enrollment ID | O20060811000195 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1174549786 | NPI | - | NPPES |
| 141031 | Other | IL | MEDICARE PROVIDER ID |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | 005 (Illinois) | Primary |
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