Provider Demographics
NPI:1215567797
Name:GREATER ELGIN FAMILY CARE CENTER INTEGRATED HEALTH HOME
Entity Type:Organization
Organization Name:GREATER ELGIN FAMILY CARE CENTER INTEGRATED HEALTH HOME
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:
Authorized Official - First Name:JASON
Authorized Official - Middle Name:
Authorized Official - Last Name:CAREY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:847-608-1344
Mailing Address - Street 1:370 SUMMIT ST
Mailing Address - Street 2:
Mailing Address - City:ELGIN
Mailing Address - State:IL
Mailing Address - Zip Code:60120-3843
Mailing Address - Country:US
Mailing Address - Phone:847-608-1344
Mailing Address - Fax:
Practice Address - Street 1:701 W SCHAUMBURG RD
Practice Address - Street 2:
Practice Address - City:STREAMWOOD
Practice Address - State:IL
Practice Address - Zip Code:60107-1262
Practice Address - Country:US
Practice Address - Phone:630-213-5500
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-01-23
Last Update Date:2020-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QF0400XAmbulatory Health Care FacilitiesClinic/CenterFederally Qualified Health Center (FQHC)