Provider Demographics
NPI:1285834986
Name:ASIAN HUMAN SERVICES FAMILY HEALTH CENTER
Entity Type:Organization
Organization Name:ASIAN HUMAN SERVICES FAMILY HEALTH CENTER
Other - Org Name:ASIAN HUMAN SERVICES ROGERS PARK CLINIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CLINIC DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:MUHAMMAD
Authorized Official - Middle Name:WASIM
Authorized Official - Last Name:PARACHA
Authorized Official - Suffix:
Authorized Official - Credentials:MD, MPH
Authorized Official - Phone:773-761-0300
Mailing Address - Street 1:2424 W PETERSON AVE
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60659-4100
Mailing Address - Country:US
Mailing Address - Phone:773-761-0300
Mailing Address - Fax:773-761-0008
Practice Address - Street 1:1400 W GREENLEAF AVE
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60626-2805
Practice Address - Country:US
Practice Address - Phone:773-761-0300
Practice Address - Fax:773-761-0008
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ASIAN HUMAN SERVICES FAMILY HEALTH CENTER
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2007-07-20
Last Update Date:2009-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QC1500XAmbulatory Health Care FacilitiesClinic/CenterCommunity Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL210035OtherWPS/MEDICARE PART B
IL210035OtherWPS/MEDICARE PART B
IL141981Medicare Oscar/Certification