FAMILY HEALTH CARE OF CISSNA PARK
NPI 1356884993
Clinic/Center - Rural Health in Cissna Park, IL

Q: What is Gibson Community Hospital Association's specialty?

The primary specialty registered for this NPI is Clinic/Center, specializing in Rural Health, with taxonomy code 261QR1300X.

Active since November 30, 2016CLIA 14D2125366 · Microscopy

510 PRAIRIE LN UNIT B, CISSNA PARK, IL 60924(815) 457-2000(815) 457-2015 Get Directions Write a Review

NPPES record last updated: February 4, 2022. Verified against the NPPES registry weekly; last sync: August 16, 2026.

Record update history: Feb 4, 2022, Sep 3, 2019 (2 updates tracked since 2019).

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About Family Health Care Of Cissna Park NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

FAMILY HEALTH CARE OF CISSNA PARK (NPI 1356884993) is a healthcare organization registered as a rural health in Cissna Park, Illinois and active in the NPI registry since November 2016. The organization holds a CLIA Microscopy certificate valid through February 5, 2027 and lists Matthew Ertel, Chief Financial Officer, as its authorized official.

NPPES Registry Identity

NPI1356884993

Entity TypeOrganization

Primary Taxonomy261QR1300X

Legal Business NameGIBSON COMMUNITY HOSPITAL ASSOCIATION

Location Address510 PRAIRIE LN UNIT BCissna Park, IL 60924-9710

Mailing Address510 Prairie Ln Unit BCissna Park, IL 60924-9710 · (815) 457-2000 · Fax (815) 457-2015

Phone(815) 457-2000

Fax(815) 457-2015

Organization SubpartYes

Authorized OfficialMatthew ErtelChief Financial Officer · (217) 784-2601

Enumeration DateNovember 30, 2016

Last NPPES UpdateFebruary 4, 20222 updates tracked since enumeration

NPPES CertifiedFebruary 4, 2022

✔ NPI 1356884993 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyClinic/Center · Rural HealthAmbulatory Health Care Facilities

Taxonomy Code261QR1300X

Also ListedClinic/Center · Multi-SpecialtyTaxonomy 261QM1300X

510 PRAIRIE LN UNIT B, Cissna Park, IL 60924

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Other Names 1

Doing Business AsFamily Health Care Of Cissna Park

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate for Provider-Performed Microscopy Procedures (PPMP) 14D2125366

Family Health Care Of Cissna Park · Cissna Park, IL

Active · expires Feb 5, 2027

CLIA Number14D2125366

Laboratory TypePhysician Office

Certificate Effective DateFebruary 6, 2025

Certificate Expiration DateFebruary 5, 2027

Laboratory DirectorDouglas P. Lanoue

Laboratory Phone(815) 457-2000

Laboratory LocationFamily Health Care Of Cissna Park510 Prairie Lane, Cissna Park, IL 60924

CLIA data matches this NPI record on: Address Name Phone

This certificate is issued to a laboratory in which a physician, midlevel practitioner or dentist performs no tests other than the microscopy procedures. This certificate permits the laboratory to also perform waived tests.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Gibson Community Hospital Association's NPI number?

The NPI number for Gibson Community Hospital Association is 1356884993. It was assigned to this organization in the NPPES registry on November 30, 2016. The provider is doing business as Family Health Care Of Cissna Park.

Where is Gibson Community Hospital Association located?

Gibson Community Hospital Association is located at 510 Prairie Ln Unit B, Cissna Park, IL 60924. The listed phone number is (815) 457-2000.

What is Gibson Community Hospital Association's specialty?

The primary specialty registered for this NPI is Clinic/Center, specializing in Rural Health, with taxonomy code 261QR1300X.

Does Gibson Community Hospital Association hold a CLIA laboratory certificate?

Yes. A Certificate for Provider-Performed Microscopy Procedures (PPMP) (number 14D2125366) is associated with this NPI, valid through February 5, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Gibson Community Hospital Association was last updated on February 4, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.