Provider Demographics
NPI:1639791569
Name:COMMUNITY HEALTH PARTNERSHIP OF ILLINOIS
Entity Type:Organization
Organization Name:COMMUNITY HEALTH PARTNERSHIP OF ILLINOIS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:ELEACE
Authorized Official - Middle Name:
Authorized Official - Last Name:SAWYERS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:312-795-0000
Mailing Address - Street 1:205 W RANDOLPH ST STE 2222
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60606-1814
Mailing Address - Country:US
Mailing Address - Phone:312-795-0000
Mailing Address - Fax:
Practice Address - Street 1:201 W KENYON RD BLDG D
Practice Address - Street 2:
Practice Address - City:CHAMPAIGN
Practice Address - State:IL
Practice Address - Zip Code:61820-7892
Practice Address - Country:US
Practice Address - Phone:312-795-0000
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-05-14
Last Update Date:2020-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QF0400XAmbulatory Health Care FacilitiesClinic/CenterFederally Qualified Health Center (FQHC)