Provider Demographics
NPI:1548157340
Name:ACCESS COMMUNITY HEALTH NETWORK
Entity type:Organization
Organization Name:ACCESS COMMUNITY HEALTH NETWORK
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANGER
Authorized Official - Prefix:
Authorized Official - First Name:NICOLE
Authorized Official - Middle Name:
Authorized Official - Last Name:JACKSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:312-526-2279
Mailing Address - Street 1:600 W FULTON ST STE 300
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60661-1259
Mailing Address - Country:US
Mailing Address - Phone:312-526-2279
Mailing Address - Fax:312-526-2326
Practice Address - Street 1:721 W LAKE ST STE 202
Practice Address - Street 2:
Practice Address - City:ADDISON
Practice Address - State:IL
Practice Address - Zip Code:60101-2035
Practice Address - Country:US
Practice Address - Phone:312-526-2279
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ACCESS COMMUNITY HEALTH NETWORK
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2025-06-23
Last Update Date:2025-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QF0400XAmbulatory Health Care FacilitiesClinic/CenterFederally Qualified Health Center (FQHC)