Provider Demographics
NPI:1740752294
Name:FRIEND FAMILY HEALTH CENTER INC
Entity Type:Organization
Organization Name:FRIEND FAMILY HEALTH CENTER INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIR. OF PROVIDER SERVICES
Authorized Official - Prefix:
Authorized Official - First Name:ANGEL
Authorized Official - Middle Name:
Authorized Official - Last Name:MCREYNOLDS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:773-795-2260
Mailing Address - Street 1:800 E 55TH ST
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60615-4906
Mailing Address - Country:US
Mailing Address - Phone:773-702-0660
Mailing Address - Fax:773-834-3756
Practice Address - Street 1:800 E 55TH ST
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60615-4906
Practice Address - Country:US
Practice Address - Phone:773-702-0660
Practice Address - Fax:773-834-3756
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-12-21
Last Update Date:2019-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management