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Physician, Advance Practice Clinician & Ancillary Provider - Network Participation Request

Physician, advanced practice clinicians and ancillary providers interested in joining the CHI Health Partners’ network must complete the following Network Participation Request form. CHI Health Partners evaluates all requests based on network adequacy requirements and existing network capacity.  If necessary, CHI Health Partners staff will contact you to request additionally required information.  Providers are added at the group tax identification number; therefore, all providers within the group must be willing to join CHI Health Partners.