Provider Demographics
NPI:1609201060
Name:ASIAN HUMAN SERVICES FAMILY HEALTH CENTER, INC
Entity Type:Organization
Organization Name:ASIAN HUMAN SERVICES FAMILY HEALTH CENTER, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINIC DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:MUHAMMAD
Authorized Official - Middle Name:W
Authorized Official - Last Name:PARACHA
Authorized Official - Suffix:
Authorized Official - Credentials:MD, MPH
Authorized Official - Phone:773-761-0010
Mailing Address - Street 1:2501 W PETERSON AVE
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60659-4108
Mailing Address - Country:US
Mailing Address - Phone:773-761-0300
Mailing Address - Fax:
Practice Address - Street 1:2501 W PETERSON AVE
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60659-4108
Practice Address - Country:US
Practice Address - Phone:773-761-0300
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-09-04
Last Update Date:2013-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QF0400XAmbulatory Health Care FacilitiesClinic/CenterFederally Qualified Health Center (FQHC)
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL14-1981Medicare PIN