Provider Demographics
NPI:1922295856
Name:FAMILY HEALTH CENTER OF PLAINFIELD, LTD
Entity Type:Organization
Organization Name:FAMILY HEALTH CENTER OF PLAINFIELD, LTD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:FARAH
Authorized Official - Middle Name:
Authorized Official - Last Name:TURK
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:815-436-1655
Mailing Address - Street 1:13550 S RTE 30
Mailing Address - Street 2:SUITE 100
Mailing Address - City:PLAINFIELD
Mailing Address - State:IL
Mailing Address - Zip Code:60544-5686
Mailing Address - Country:US
Mailing Address - Phone:815-436-1655
Mailing Address - Fax:815-436-1656
Practice Address - Street 1:13550 S RTE 30
Practice Address - Street 2:SUITE 100
Practice Address - City:PLAINFIELD
Practice Address - State:IL
Practice Address - Zip Code:60544-5686
Practice Address - Country:US
Practice Address - Phone:815-436-1655
Practice Address - Fax:815-436-1656
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-09-25
Last Update Date:2012-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036099659207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL260668811OtherTAX ID