CHICAGO HEALTH OUTREACH – Federally Qualified Health Center (FQHC), NPI 1538294483

CHICAGO HEALTH OUTREACH is a healthcare provider. based in Chicago, Illinois. specializing in Federally Qualified Health Center (FQHC). The organization holds a License No. ========= (IL). The NPI Number for CHICAGO HEALTH OUTREACH is 1538294483

Main info

Organization
Name
CHICAGO HEALTH OUTREACH
NPI
1538294483
Phone
(773) 275-2586
Address
4009 N BROADWAY ST
Authorized Official
JIMMY VALENTIN SR. DIRECTOR, HEALTH INFORMATION SY
Enumeration Date
22 February 2007
Last Update Date
1 April 2024
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience72
Completeness80
Years active:19State licenses:1Digital endpointsUpdated within 12 months

Provider Addresses for CHICAGO HEALTH OUTREACH

  • 4009 N BROADWAY ST

    CHICAGO, IL 606132110

    Phone: (773) 275-2586

    Fax: (773) 751-4175

    Type: Mailing

  • 1015 W LAWRENCE AVE

    CHICAGO, IL 606405017

    Phone: (773) 751-4129

    Fax: (773) 751-4175

    Type: Mailing

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2010-09-08

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Past revalidation due date

Earliest CMS due date was 2025-09-30 (254 days ago).

Enrollment records

2

Earliest due date

2025-09-30

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
O20040115000481OClinic/Group PracticeIL2025-09-30
O20100908001025OFederally Qualified Health Center (Fqhc)IL2026-06-30

What to do next

  • Verify current status on the CMS Revalidation Lookup Tool immediately.
  • Complete revalidation in PECOS or contact your Medicare Administrative Contractor (MAC).
  • Overdue revalidation can lead to deactivation of Medicare billing privileges.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 60613)

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Reviews

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Frequently asked questions

Where can patients find CHICAGO HEALTH OUTREACH's NPI?
You can confirm CHICAGO HEALTH OUTREACH with NPI 1538294483; it appears in the national provider directory.
Is CHICAGO HEALTH OUTREACH's NPI currently valid?
The extract we use shows CHICAGO HEALTH OUTREACH as active.
What field does CHICAGO HEALTH OUTREACH work in?
You can think of CHICAGO HEALTH OUTREACH as practicing within Federally Qualified Health Center (FQHC). Clinical services aligned with this taxonomy classification.
What location metadata exists for CHICAGO HEALTH OUTREACH?
The page summarizes Chicago, Illinois for CHICAGO HEALTH OUTREACH; expand the address list for detail.
Does Medicare enrollment show here?
Medicare enrollment screens are separate from the basic NPI extract shown here.

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