Roosevelth High SHC – Federally Qualified Health Center (FQHC), NPI 1700044039

Roosevelth High SHC is a healthcare provider. based in Chicago, Illinois. specializing in Federally Qualified Health Center (FQHC). The organization holds a License No. 004 (IL). The NPI Number for Roosevelth High SHC is 1700044039

Main info

Organization
Name
Roosevelth High SHC
NPI
1700044039
Phone
(773) 751-7800
Address
1301 W DEVON AVE
Authorized Official
NICOLE WILLIS CEO
Enumeration Date
22 May 2008
Last Update Date
4 October 2023
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience65
Completeness80
Years active:18State licenses:1Digital endpointsUpdated within 12 months

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Provider Addresses for Roosevelth High SHC

  • 1301 W DEVON AVE

    CHICAGO, IL 606601329

    Phone: (773) 751-7800

    Fax: (773) 634-7962

    Type: Mailing

  • 3048, North Wilton Avenue, Boystown, Lake View, Lakeview, Chicago, Lake View Township, Cook County, Illinois, 60657, United States

    2ND FLOOR

    CHICAGO, IL 606576740

    Phone: (773) 296-7544

    Fax: (773) 296-7637

    Type: Mailing

  • Roosevelt High School, 3436, West Wilson Avenue, Albany Park, Chicago, Jefferson Township, Cook County, Illinois, 60625, United States

    CHICAGO, IL 606255318

    Phone: (773) 866-0818

    Fax: (773) 866-9069

    Type: Location

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.

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Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

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

No Medicare enrollment or revalidation data available for this provider in our database.

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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 60660)

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Reviews

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Frequently asked questions

How do I look up Roosevelth High SHC by NPI?
Use NPI 1700044039 when you need to reference Roosevelth High SHC in forms, claims, or directories.
Is Roosevelth High SHC's enrollment marked active?
An active flag here means the NPI record is not in a deactivated state.
Does Roosevelth High SHC list a primary specialty?
If you are matching referrals, note Federally Qualified Health Center (FQHC) for Roosevelth High SHC. Clinical services aligned with this taxonomy classification.
What location metadata exists for Roosevelth High SHC?
The page summarizes Chicago, Illinois for Roosevelth High SHC; expand the address list for detail.
How can I contact Roosevelth High SHC?
Phone or fax may appear on the official NPI record when supplied — verify before relying on them.

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