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

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: July 19, 2026.

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

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

What is GIBSON COMMUNITY HOSPITAL ASSOCIATION's NPI number?

The NPI number assigned to this healthcare provider is 1356884993, enumerated as an "organization" on November 30, 2016.

Where is the provider located?

The provider is located at 510 PRAIRIE LN UNIT B CISSNA PARK, IL 60924 and the phone number is (815) 457-2000.

What is the provider's specialty?

Clinic/Center with taxonomy code 261QR1300X and a focus in Rural Health.